Provider Demographics
NPI:1477139772
Name:ARBELAEZ, SANDRA (MT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:ARBELAEZ
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 SHERWOOD AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3941
Mailing Address - Country:US
Mailing Address - Phone:201-282-7475
Mailing Address - Fax:
Practice Address - Street 1:61 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE CITY
Practice Address - State:NJ
Practice Address - Zip Code:07753-6426
Practice Address - Country:US
Practice Address - Phone:732-456-6337
Practice Address - Fax:732-456-6337
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00813400225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist