Doctor Name: | SANDRA DEAN |
NPI Number: | 1114172657 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 26NJ00071500 |
Business Practice Address: | 185 Roseberry St Phillipsburg, NJ - 088651690 |
Business Phone Number: | 9088596775 |
Business Fax Number: | |
Mailing Address: | 185 Roseberry St, PHILLIPSBURG |
State: | NJ |
Postal Code: | 088651690 |
Phone Number: | 9088596775 |
Fax Number: | |
NPI Enumeration Date: | 11/25/2008 |
NPI Last Update Date: | 11/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | 26NJ00071500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |