Edris, Sandra Marie

Edris, Sandra Marie is an sole proprietor health care provider with primary practice located at 777 Seaview Ave , Staten Island NY 10305-3409. She recently has only one registered license in Nursing Service Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Edris, Sandra Marie can be contacted via phone (718) 667-2591.

Contact Information

Primary practice address
777 Seaview Ave Staten Island NY 10305-3409
Phone: (718) 667-2591
Fax: (718) 667-2586
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X 583217 New York

Profile Details

NPI number 1447754924
LBN Legal business name Edris, Sandra Marie
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 20th, 2018
Last updated Mar 20th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447754924 NPPES
New York MEDICAID 2997157

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