Provider Demographics
NPI:1164599882
Name:SANDLER, ENA MICHELE (MSRDLDN)
Entity Type:Individual
Prefix:MS
First Name:ENA
Middle Name:MICHELE
Last Name:SANDLER
Suffix:
Gender:F
Credentials:MSRDLDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 BLUEBERRY HILL LN
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-2015
Mailing Address - Country:US
Mailing Address - Phone:978-440-8846
Mailing Address - Fax:978-440-8846
Practice Address - Street 1:37 BLUEBERRY HILL LN
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-2015
Practice Address - Country:US
Practice Address - Phone:978-440-8846
Practice Address - Fax:978-440-8846
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA903133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTO626Medicare ID - Type Unspecified