Provider Demographics
NPI:1881782571
Name:CAMPER, SANDY CAROLYN (MAC, LAC)
Entity type:Individual
Prefix:MS
First Name:SANDY
Middle Name:CAROLYN
Last Name:CAMPER
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 254
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NY
Mailing Address - Zip Code:12022-0254
Mailing Address - Country:US
Mailing Address - Phone:518-658-0594
Mailing Address - Fax:
Practice Address - Street 1:3 COMPUTER DR W STE 126A
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1621
Practice Address - Country:US
Practice Address - Phone:518-458-9113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002402-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist