1821454166 NPI number — DEPARTMENT OF VETERANS AFFAIRS

Table of content: DR. SANDRA LEE PENSIERI DPM (NPI 1891721312)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821454166 NPI number — DEPARTMENT OF VETERANS AFFAIRS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEPARTMENT OF VETERANS AFFAIRS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821454166
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/31/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
58 PATTERSON LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWINGTON
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03801-2806
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
950 CAMPBELL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06516-2770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-932-5711
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/31/2015

Additional Information

Authorized Official

Authorized Official Last Name:
ANTON
Authorized Official First Name:
CASSANDRA
Authorized Official Middle Name:
Authorized Official Title or Position:
REGISTERED OCCUPATIONAL THERAPIST
Authorized Official Telephone Number:
203-687-8792

Provider Taxonomy Codes

  • Taxonomy code: 283X00000X , with the licence number:  11362 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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