Healthcare Provider Details

I. General information

NPI: 1386580199
Provider Name (Legal Business Name): SANDRA JEAN BURNETT LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 AVENUE OF AMERICAS
NEW WINDSOR NY
12553-4752
US

IV. Provider business mailing address

70 HIGH POINT CIR
NEWBURGH NY
12550-7236
US

V. Phone/Fax

Practice location:
  • Phone: 845-629-3757
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number016092-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: