MEDICARE: MS. SANDRA JOSEPH NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	F4300311	NY

General Provider Information

NPI Number	:	1346452208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA JOSEPH NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	20 WATERSIDE PLAZA
Second Line	:	#8G
City	:	NYC
State	:	NY
Zip	:	10010
Country	:	US
Telephone Number	:	646-391-5445
Fax Number	:

Provider Business Practice Location Address
First Line	:	622 WEST 168 STREET
Second Line	:	MILSTEIN PAVILLION MEDICAL INTENSIVE CARE UNIT B
City	:	NEW YORK CITY
State	:	NY
Zip	:	10032
Country	:	US
Telephone Number	:	212-305-4141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	07/08/2007

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