Provider Demographics
NPI:1013552058
Name:SANDER, NINA CHRISTIE
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:CHRISTIE
Last Name:SANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 W 23RD ST STE 1400
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4101
Mailing Address - Country:US
Mailing Address - Phone:212-582-1566
Mailing Address - Fax:212-586-1272
Practice Address - Street 1:71 W 23RD ST STE 1400
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4101
Practice Address - Country:US
Practice Address - Phone:212-582-1566
Practice Address - Fax:212-586-1272
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program