Provider Demographics
NPI:1568594018
Name:KANDER, TAMI (MS, OTR L)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:
Last Name:KANDER
Suffix:
Gender:F
Credentials:MS, 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:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:COPAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12516-0697
Mailing Address - Country:US
Mailing Address - Phone:781-475-9432
Mailing Address - Fax:
Practice Address - Street 1:707 CENTER HILL ROAD
Practice Address - Street 2:
Practice Address - City:COPAKE
Practice Address - State:NY
Practice Address - Zip Code:12516-1503
Practice Address - Country:US
Practice Address - Phone:781-475-9432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7737174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist