Provider Demographics
NPI:1003992256
Name:HAMBERGER, SANDRA FLORENCE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:FLORENCE
Last Name:HAMBERGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 09 JEWEL AVENUE FLUSHING
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11365-3423
Mailing Address - Country:US
Mailing Address - Phone:718-969-8087
Mailing Address - Fax:718-470-9402
Practice Address - Street 1:173 09 JEWEL AVENUE
Practice Address - Street 2:FLUSHING
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11365-3423
Practice Address - Country:US
Practice Address - Phone:718-969-8087
Practice Address - Fax:718-470-9402
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR3303111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01516Medicare ID - Type Unspecified