Provider Demographics
NPI:1174785000
Name:SANCHEZ, IRVIN RAFAEL (MD)
Entity type:Individual
Prefix:
First Name:IRVIN
Middle Name:RAFAEL
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-4063
Mailing Address - Country:US
Mailing Address - Phone:315-785-8509
Mailing Address - Fax:
Practice Address - Street 1:826 WASHINGTON ST FL 3
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-4063
Practice Address - Country:US
Practice Address - Phone:603-361-9051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263816207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology