Healthcare Provider Details

I. General information

NPI: 1730236878
Provider Name (Legal Business Name): SANDRA A THOMAIER NP, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 BANK ROW ST STE 2S
GREENFIELD MA
01301-3598
US

IV. Provider business mailing address

38 LUCY FISKE RD
SHELBURNE FALLS MA
01370-9735
US

V. Phone/Fax

Practice location:
  • Phone: 413-773-9505
  • Fax: 413-773-9595
Mailing address:
  • Phone: 413-625-9482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number130583
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: