Provider Demographics
NPI:1134206857
Name:NAIRN, SANDRA J (DO)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:NAIRN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER UNIVERSITY EMGERNCY PHYSICIANS
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2351
Practice Address - Fax:856-968-8272
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB511792080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ010006265 00OtherAMERICHOICE
NJ60005652OtherHORIZON NJ HEALTH
NJP3362562OtherOXFORD
NJ3498050OtherAETNA
NJ6883800Medicaid
NJ12103252OtherUNITED HEALTHCARE
NJ19053OtherUNITED HEALTHCARE
NJ674203OtherAMERIHEALTH PPO/PA BS
NJ6759623OtherCIGNA
NJ0507534000OtherAMERIHEALTH/KEYSTONE/IBC
NJ674203OtherAMERIHEALTH PPO/PA BS
NJ674203 SZFMedicare PIN