Provider Demographics
NPI:1609199819
Name:JOSEPH, SANDRA (RN,BSN)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:MISS
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:JEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,BSN
Mailing Address - Street 1:80 BAYNE ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1223
Mailing Address - Country:US
Mailing Address - Phone:914-275-3770
Mailing Address - Fax:203-549-0774
Practice Address - Street 1:80 BAYNE ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1223
Practice Address - Country:US
Practice Address - Phone:914-275-3770
Practice Address - Fax:203-549-0774
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY495880-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse