Provider Demographics
NPI:1508048539
Name:PABON, SANDRA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:PABON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 NEWMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2406
Mailing Address - Country:US
Mailing Address - Phone:347-728-0933
Mailing Address - Fax:
Practice Address - Street 1:223 NEWMAN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2406
Practice Address - Country:US
Practice Address - Phone:347-728-0933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007364174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist