Provider Demographics
NPI:1437466620
Name:BORDONARO, SANDRA (SPEECH THERAPIST)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:BORDONARO
Suffix:
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14305-1478
Mailing Address - Country:US
Mailing Address - Phone:716-298-5048
Mailing Address - Fax:
Practice Address - Street 1:28 HARDING AVE
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-6021
Practice Address - Country:US
Practice Address - Phone:716-478-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant