Provider Demographics
NPI:1467527200
Name:BECKER, SANDRA JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:JEAN
Last Name:BECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 CONTINENTAL LN
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-2001
Mailing Address - Country:US
Mailing Address - Phone:610-296-1238
Mailing Address - Fax:610-296-1238
Practice Address - Street 1:315 CONTINENTAL LN
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-2001
Practice Address - Country:US
Practice Address - Phone:610-296-1238
Practice Address - Fax:610-296-1238
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029938E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics