Provider Demographics
NPI:1114993888
Name:HOLLAR, SANDI M (PT)
Entity Type:Individual
Prefix:
First Name:SANDI
Middle Name:M
Last Name:HOLLAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HAYES DR
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-1189
Mailing Address - Country:US
Mailing Address - Phone:607-738-2837
Mailing Address - Fax:607-846-3744
Practice Address - Street 1:5 HAYES DR
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-1189
Practice Address - Country:US
Practice Address - Phone:607-738-2837
Practice Address - Fax:607-846-3744
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA7394Medicare ID - Type Unspecified