Provider Demographics
NPI:1528221967
Name:MCGREGOR, SANDRA PATRICIA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:PATRICIA
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14229 231ST ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3627
Mailing Address - Country:US
Mailing Address - Phone:718-949-9307
Mailing Address - Fax:
Practice Address - Street 1:14229 231ST ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-3627
Practice Address - Country:US
Practice Address - Phone:718-949-9307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY656162-1163W00000X
NY274460-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse