Healthcare Provider Details

I. General information

NPI: 1891877502
Provider Name (Legal Business Name): SANDRA K YAFFE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 CANAL STREET
NASHUA NH
03064
US

IV. Provider business mailing address

94 AMHERST STREET
AMHERST NH
03031
US

V. Phone/Fax

Practice location:
  • Phone: 603-882-6333
  • Fax: 603-889-5460
Mailing address:
  • Phone: 603-886-0579
  • Fax: 603-886-0163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number5390
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number1576
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: