Doctor Name: | PAMELA SANDBORN |
NPI Number: | 1225406473 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 485924 |
Business Practice Address: | 803 Grant Ave Lake Katrine, NY - 124495352 |
Business Phone Number: | 8453315064 |
Business Fax Number: | |
Mailing Address: | 139 Pine Grove Ave, KINGSTON |
State: | NY |
Postal Code: | 124015452 |
Phone Number: | 8458074236 |
Fax Number: | |
NPI Enumeration Date: | 09/04/2015 |
NPI Last Update Date: | 09/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | 485924 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |