Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 420274 | NY |
NPI | 1083701569 |
---|---|
Provider Name | Sandra L Neubauer |
First Address | Corfu, NY 14036-9796 |
Second Address | Amherst, NY 14228-2105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 27/07/2021 |