MEDICARE: DR. RHONDA ANN SANDERSON MD

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	207VG0400X	Gynecology Physician	MA46310	NJ
2	207V00000X	Obstetrics & Gynecology Physician	25MA04631000	NJ

General Provider Information

NPI Number	:	1982627253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RHONDA ANN SANDERSON MD

Provider Business Mailing Address
First Line	:	PO BOX 22581
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-2581
Country	:	US
Telephone Number	:	856-669-6050
Fax Number	:	856-528-3117

Provider Business Practice Location Address
First Line	:	27 MOUNTAIN BLVD STE 6
Second Line	:
City	:	WARREN
State	:	NJ
Zip	:	07059-5605
Country	:	US
Telephone Number	:	973-736-1100
Fax Number	:	888-209-8985

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	03/12/2021

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