Provider Demographics
NPI:1174887566
Name:FIGUEROA, SANDRA
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 E 163RD ST
Mailing Address - Street 2:2C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-2915
Mailing Address - Country:US
Mailing Address - Phone:646-245-7761
Mailing Address - Fax:
Practice Address - Street 1:830 E 163RD ST
Practice Address - Street 2:2C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-2915
Practice Address - Country:US
Practice Address - Phone:646-245-7761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24646174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist