Provider Demographics
NPI:1750260253
Name:SANDS, WILLIAM DOUGLAS (CSCS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DOUGLAS
Last Name:SANDS
Suffix:
Gender:M
Credentials:CSCS
Other - Prefix:
Other - First Name:WILL
Other - Middle Name:DOUGLAS
Other - Last Name:SANDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CSCS
Mailing Address - Street 1:467 CENTRAL PARK W APT 9E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3886
Mailing Address - Country:US
Mailing Address - Phone:336-408-5713
Mailing Address - Fax:
Practice Address - Street 1:2162 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6620
Practice Address - Country:US
Practice Address - Phone:917-409-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7248072855171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach