Provider Demographics
NPI:1912334780
Name:PEINADO, SANDRA CONSTANTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:CONSTANTINE
Last Name:PEINADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1 PINEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-3415
Mailing Address - Country:US
Mailing Address - Phone:973-379-4007
Mailing Address - Fax:973-379-5576
Practice Address - Street 1:1 PINEWOOD CT
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-3415
Practice Address - Country:US
Practice Address - Phone:973-379-4007
Practice Address - Fax:973-379-5576
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04658500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine