Provider Demographics
NPI:1629572979
Name:SANDLER, DARA (MS, RD, CDN)
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:
Last Name:SANDLER
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 FORSTER PL
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-8128
Mailing Address - Country:US
Mailing Address - Phone:917-841-1778
Mailing Address - Fax:
Practice Address - Street 1:101 FORSTER PL
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-8128
Practice Address - Country:US
Practice Address - Phone:917-841-1778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY968051133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered