Provider Demographics
NPI:1922543644
Name:SANCHEZ, ISAURA (MS ED)
Entity Type:Individual
Prefix:MS
First Name:ISAURA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10119 132ND ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-2348
Mailing Address - Country:US
Mailing Address - Phone:917-455-4534
Mailing Address - Fax:
Practice Address - Street 1:10119 132ND ST
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-2348
Practice Address - Country:US
Practice Address - Phone:917-455-4534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1096698171390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program