| Doctor Name: | MRS. SANDRA LEE CONKLIN |
| NPI Number: | 1457637720 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | REGISTERED NURSE |
| License Number: | 344529-1 |
| Business Practice Address: | 138 North Court Street, Veterans Memorial Building Wampsville, NY - 131630608 |
| Business Phone Number: | 3153662327 |
| Business Fax Number: | 3153662599 |
| Mailing Address: | 138 North Court Street,, Veterans Memorial Building WAMPSVILLE |
| State: | NY |
| Postal Code: | 131630608 |
| Phone Number: | 3153662327 |
| Fax Number: | 3153662599 |
| NPI Enumeration Date: | 10/31/2011 |
| NPI Last Update Date: | 10/31/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 344529-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |