Provider Demographics
NPI:1679801591
Name:KRIS, SANDY (MS PT)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:KRIS
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 RUGBY RD
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1120
Mailing Address - Country:US
Mailing Address - Phone:516-569-2343
Mailing Address - Fax:
Practice Address - Street 1:333 RUGBY RD
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1120
Practice Address - Country:US
Practice Address - Phone:516-569-2343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007607-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist