Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 012174-1 | NY |
N | 103T00000X | Psychologist | 012174-1 | NY |
N | 103G00000X | Clinical Psychologist | 012174-1 | NY |
N | 103TC0700X | Clinical Psychologist | 012174-1 | NY |
NPI | 1013066778 |
---|---|
Provider Name | Dr. Shara Sand |
First Address | New York, NY 10025-3562 |
Second Address | New York, NY 10025-3562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 08/07/2007 |