Provider Demographics
NPI:1790758977
Name:SANDROW, SHANA (DC)
Entity Type:Individual
Prefix:DR
First Name:SHANA
Middle Name:
Last Name:SANDROW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 ATCO AVE
Mailing Address - Street 2:
Mailing Address - City:ATCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08004-1937
Mailing Address - Country:US
Mailing Address - Phone:856-753-7225
Mailing Address - Fax:856-768-8979
Practice Address - Street 1:2129 ATCO AVE
Practice Address - Street 2:
Practice Address - City:ATCO
Practice Address - State:NJ
Practice Address - Zip Code:08004-1937
Practice Address - Country:US
Practice Address - Phone:856-753-7225
Practice Address - Fax:856-768-8979
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00643500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor