Provider Demographics
NPI:1679838072
Name:SANDERS, DENISE (MSED, TSHH)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MSED, TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 GENESEE AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5923
Mailing Address - Country:US
Mailing Address - Phone:201-682-6763
Mailing Address - Fax:
Practice Address - Street 1:739 QUEEN ANNE RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3332
Practice Address - Country:US
Practice Address - Phone:201-682-6763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist