Doctor Name: | SHAWNA SANDY |
NPI Number: | 1356779086 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | MA056542 |
Business Practice Address: | 334 Main St Dickson City, PA - 185191668 |
Business Phone Number: | 5703071767 |
Business Fax Number: | 5703071778 |
Mailing Address: | 334 Main St, DICKSON CITY |
State: | PA |
Postal Code: | 185191668 |
Phone Number: | 5703071767 |
Fax Number: | 5703071778 |
NPI Enumeration Date: | 10/15/2013 |
NPI Last Update Date: | 10/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | MA056542 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |