Provider Demographics
NPI:1780469080
Name:ZOMBRE, SANDRINE BENEWENDE
Entity type:Individual
Prefix:
First Name:SANDRINE
Middle Name:BENEWENDE
Last Name:ZOMBRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 PARKBROOK DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1871
Mailing Address - Country:US
Mailing Address - Phone:217-418-8690
Mailing Address - Fax:
Practice Address - Street 1:1505 PARKBROOK DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1871
Practice Address - Country:US
Practice Address - Phone:217-418-8690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUY623430374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide