Provider Demographics
NPI:1790958056
Name:ZAGELBAUM, SANDRA FINK (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:FINK
Last Name:ZAGELBAUM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1453 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5232
Mailing Address - Country:US
Mailing Address - Phone:718-951-2072
Mailing Address - Fax:718-486-5553
Practice Address - Street 1:1453 E 26TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-5232
Practice Address - Country:US
Practice Address - Phone:718-951-2072
Practice Address - Fax:718-486-5553
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048892122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist