Provider Demographics
NPI:1497262422
Name:CLIBANOFF, SANDEE
Entity Type:Individual
Prefix:
First Name:SANDEE
Middle Name:
Last Name:CLIBANOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1485
Mailing Address - Country:US
Mailing Address - Phone:267-288-7756
Mailing Address - Fax:
Practice Address - Street 1:329 VILLAGE RD E
Practice Address - Street 2:
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-2001
Practice Address - Country:US
Practice Address - Phone:609-275-6368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician