Provider Demographics
NPI:1437445681
Name:WINIEWICZ, SANDRA ROSE (DPM)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:ROSE
Last Name:WINIEWICZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 FLAGSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-1662
Mailing Address - Country:US
Mailing Address - Phone:570-574-6182
Mailing Address - Fax:856-482-7286
Practice Address - Street 1:6 FLAGSTONE DR
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-1662
Practice Address - Country:US
Practice Address - Phone:570-574-6182
Practice Address - Fax:856-482-7286
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00310100213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery