Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 207382-1 | NY |
NPI | 1245211309 |
---|---|
Provider Name | Dr. Sandra Myriam Fefer-Sadler |
First Address | Bardonia, NY 10954-2152 |
Second Address | Haverstraw, NY 10927-1810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 30/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01771791 | (05) | NY |
132632069 | BUSINESS NPI (01) | NY |
227 | HUDSON HEALTH PLAN (01) | NY |
232ZA1 | EMPIRE BC AND BS (01) | NY |
G58930 | (02) | NY |