Provider Demographics
NPI:1689233405
Name:SANDERS, IRIS
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7607 FONTAINEBLEAU DR APT 2355
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3820
Mailing Address - Country:US
Mailing Address - Phone:301-357-5821
Mailing Address - Fax:
Practice Address - Street 1:3005 BLADENSBURG RD NE APT 319
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2240
Practice Address - Country:US
Practice Address - Phone:202-581-2364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant