Provider Demographics
NPI:1578849550
Name:SANCHEZ, JOHANNA REINA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:JOHANNA
Middle Name:REINA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3136 PERRY AVE
Mailing Address - Street 2:APT 1-B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-4139
Mailing Address - Country:US
Mailing Address - Phone:347-209-9148
Mailing Address - Fax:
Practice Address - Street 1:3136 PERRY AVE
Practice Address - Street 2:APT 1-B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-4139
Practice Address - Country:US
Practice Address - Phone:347-209-9148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-23
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306814-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse