Provider Demographics
NPI:1346710126
Name:BISCHOFF, SANDRA (RPH)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:BISCHOFF
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GARLAND ST
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-8305
Mailing Address - Country:US
Mailing Address - Phone:845-534-5866
Mailing Address - Fax:
Practice Address - Street 1:25 GARLAND ST
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-8305
Practice Address - Country:US
Practice Address - Phone:845-534-5866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0005237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist