Provider Demographics
NPI:1821051582
Name:SANDHERR, JOANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:SANDHERR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 W CHESTER PIKE
Mailing Address - Street 2:SUITE 409
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-5657
Mailing Address - Country:US
Mailing Address - Phone:610-738-8016
Mailing Address - Fax:610-918-6316
Practice Address - Street 1:701 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4412
Practice Address - Country:US
Practice Address - Phone:610-431-5000
Practice Address - Fax:610-918-6316
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001400L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S34875Medicare UPIN
667113Medicare ID - Type Unspecified