Provider Demographics
NPI:1033346523
Name:SANDE, MARIA (BS)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:SANDE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 64TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-5806
Mailing Address - Country:US
Mailing Address - Phone:917-412-5864
Mailing Address - Fax:
Practice Address - Street 1:8460 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-2544
Practice Address - Country:US
Practice Address - Phone:718-298-6161
Practice Address - Fax:718-298-6206
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY600989051174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist