Sander, Jerry

Sander, Jerry is an sole proprietor health care provider with primary practice located at 92 South St , Warwick NY 10990-1618. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Sander, Jerry can be contacted via phone (845) 986-4462.

Contact Information

Primary practice address
92 South St Warwick NY 10990-1618
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R0351191 New York

Profile Details

NPI number 1033243951
LBN Legal business name Sander, Jerry
Credentials L.C.S.W.-R.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 15th, 2007
Last updated Dec 7th, 2012 - about 14 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 1033243951 NPPES
New York Other A300075678 MEDICARE PTAN

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