1114204989 NPI number — RACHAEL MAGNER SANDLER B.A.

Table of content: RACHAEL MAGNER SANDLER B.A. (NPI 1114204989)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114204989 NPI number — RACHAEL MAGNER SANDLER B.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANDLER
Provider First Name:
RACHAEL
Provider Middle Name:
MAGNER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
B.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAGNER
Provider Other First Name:
RACHAEL
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.A.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1114204989
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 MOTT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWALK
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06850
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-855-8765
Provider Business Mailing Address Fax Number:
203-838-3325

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 MOTT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWALK
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-855-8765
Provider Business Practice Location Address Fax Number:
203-838-3325
Provider Enumeration Date:
11/08/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)