Provider Demographics
NPI:1073529913
Name:RAY, SANDRA LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LEE
Last Name:RAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:LEE
Other - Last Name:FARNELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:507 WILLIAMSTOWN NEW FREEDOM RD
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-1775
Mailing Address - Country:US
Mailing Address - Phone:856-629-1199
Mailing Address - Fax:856-629-3909
Practice Address - Street 1:507 WILLIAMSTOWN NEW FREEDOM RD
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-1775
Practice Address - Country:US
Practice Address - Phone:856-629-1199
Practice Address - Fax:856-629-3909
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00304500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2412136000OtherAMERIHEALTH
NJ9729440OtherCIGNA
PA001746768OtherHIGHMARK BLUE SHIELD
NJK55589OtherHORIZON BLUE CROSS BLUE SHIELD NEW JERSEY
NJ192487OtherCHN
PA001746768OtherPERSONAL CHOICE
NJ222825665OtherAMERICAN HEALTH SPECIALIT
NJ222825665OtherALANTICARE
PA2412136000OtherKEYSTONE
NJ3365392OtherAETNA HEALTH INS.
NJK55589OtherHORIZON BC BS PLUS
NJ9729440OtherCIGNA