| Doctor Name: | SANDRA KINZER |
| NPI Number: | 1760800494 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 681420 |
| Business Practice Address: | 21 Cammerer Ave East Rockaway, NY - 115181905 |
| Business Phone Number: | 5165967669 |
| Business Fax Number: | |
| Mailing Address: | 21 Cammerer Ave, EAST ROCKAWAY |
| State: | NY |
| Postal Code: | 115181905 |
| Phone Number: | 5165967669 |
| Fax Number: | |
| NPI Enumeration Date: | 03/31/2014 |
| NPI Last Update Date: | 03/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 681420 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |