Provider Demographics
NPI:1245454354
Name:STEIN, SANDRA (MS, RD, CDE, CDN)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:MS, RD, CDE, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHOICES WOMEN'S HEALTH CENTER
Mailing Address - Street 2:147-32 JAMAICA AVENUE
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435
Mailing Address - Country:US
Mailing Address - Phone:347-967-9868
Mailing Address - Fax:
Practice Address - Street 1:CHOICES WOMEN'S HEALTH CENTER
Practice Address - Street 2:147-32 JAMAICA AVENUE
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435
Practice Address - Country:US
Practice Address - Phone:718-786-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0036441133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400161692Medicare PIN
NY0036441OtherCDN
804176OtherRD