Provider Demographics
NPI:1750709135
Name:LAATS, SANDRA SIEWERT
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SIEWERT
Last Name:LAATS
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 1:836 DICKINSON DR
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-3801
Mailing Address - Country:US
Mailing Address - Phone:339-223-7793
Mailing Address - Fax:
Practice Address - Street 1:332 BROAD ST STE A
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:NY
Practice Address - Zip Code:14892-1345
Practice Address - Country:US
Practice Address - Phone:607-948-4047
Practice Address - Fax:607-565-2200
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist