O E Sandoval MD PC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

O E SANDOVAL MD PC

Practice address

569 35TH St
Union City, NJ 07087-2563

Phone

(201) 866-6970

Fax

(201) 866-7144

NPI assigned

Apr 15, 2016

Last updated

Apr 15, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Oscar E Sandoval, MD

Title

Director

Phone

(201) 866-9670

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460678400000",
    "number": "1902250913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 35TH ST",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872563",
            "telephone_number": "201-866-6970",
            "fax_number": "201-866-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 35TH ST",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872563",
            "telephone_number": "201-866-6970",
            "fax_number": "201-866-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O E SANDOVAL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-15",
        "last_updated": "2016-04-15",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "OSCAR",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-866-9670",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3585905",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25MA045843",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.