Provider Demographics
NPI:1972545663
Name:BIRNBAUM, SANDRA F (PT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:F
Last Name:BIRNBAUM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 29TH ST NW
Mailing Address - Street 2:#300
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5531
Mailing Address - Country:US
Mailing Address - Phone:202-483-3697
Mailing Address - Fax:
Practice Address - Street 1:9715 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 415
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3320
Practice Address - Country:US
Practice Address - Phone:301-340-9200
Practice Address - Fax:301-279-9358
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15703174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist