Provider Demographics
NPI:1497908941
Name:SANDLER, EILEEN BETH (MA)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:BETH
Last Name:SANDLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3941
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12402-3941
Mailing Address - Country:US
Mailing Address - Phone:845-331-8610
Mailing Address - Fax:845-331-1752
Practice Address - Street 1:163 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:HURLEY
Practice Address - State:NY
Practice Address - Zip Code:12443-5219
Practice Address - Country:US
Practice Address - Phone:845-331-8610
Practice Address - Fax:845-331-1752
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP4157235Z00000X
NY009147235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist