Provider Demographics
NPI:1497898019
Name:TAUB, SANDRA B (PHD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:B
Last Name:TAUB
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-3023
Mailing Address - Country:US
Mailing Address - Phone:914-693-3954
Mailing Address - Fax:
Practice Address - Street 1:340 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-3023
Practice Address - Country:US
Practice Address - Phone:914-693-3954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005801-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV30821Medicare ID - Type UnspecifiedPSYCHOLOGIST