Basic Information
| Provider Information | |||||||||
| NPI: | 1861892457 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SANDMAN | ||||||||
| FirstName: | VICTOR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1181 AQUIDNECK AVE | ||||||||
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| City: | MIDDLETOWN | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028425255 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4013670190 | ||||||||
| FaxNumber: | 4016193752 | ||||||||
| Practice Location | |||||||||
| Address1: | 73 VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028425234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017267100 | ||||||||
| FaxNumber: | 4012892634 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2014 | ||||||||
| LastUpdateDate: | 06/20/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT02746 | RI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.