Provider Demographics
NPI:1619421823
Name:VERDE-SANCHEZ, IVAN (MD)
Entity type:Individual
Prefix:MR
First Name:IVAN
Middle Name:
Last Name:VERDE-SANCHEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 N BUFFALO DR APT 1092
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0278
Mailing Address - Country:US
Mailing Address - Phone:702-504-6858
Mailing Address - Fax:
Practice Address - Street 1:99 GOLDEN HILL DR
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6442
Practice Address - Country:US
Practice Address - Phone:845-340-3390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-05
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP133358207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine