Provider Demographics
NPI:1417131822
Name:MAYER, SANDRA L (RN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:MAYER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 OAKLAND AVE
Mailing Address - Street 2:APARTMENT 6
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1559
Mailing Address - Country:US
Mailing Address - Phone:732-586-1078
Mailing Address - Fax:609-588-2950
Practice Address - Street 1:230 OAKLAND AVE
Practice Address - Street 2:APARTMENT 6
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1559
Practice Address - Country:US
Practice Address - Phone:732-586-1078
Practice Address - Fax:609-588-2950
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR11200200163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse