Provider Demographics
NPI:1285814384
Name:GAUKER, SANDRA LEE (RN, APN, C)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LEE
Last Name:GAUKER
Suffix:
Gender:F
Credentials:RN, APN, C
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:LEE
Other - Last Name:GAUKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:184 HIAWATHA BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-3643
Mailing Address - Country:US
Mailing Address - Phone:201-996-2446
Mailing Address - Fax:201-996-4609
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1914
Practice Address - Country:US
Practice Address - Phone:201-996-2446
Practice Address - Fax:201-996-4609
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC05075500364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult