Provider Demographics
NPI:1396868378
Name:SANDS, DONNA L (DC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:L
Last Name:SANDS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 OAKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2323
Mailing Address - Country:US
Mailing Address - Phone:973-761-0516
Mailing Address - Fax:
Practice Address - Street 1:149 OAKVIEW AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2323
Practice Address - Country:US
Practice Address - Phone:973-761-0516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010501111N00000X
NJ38MC00615300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY200552587OtherTAX ID
NY200552587OtherTAX ID