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General NPI Number Information
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NPI Number | 1013905132
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Entity Type | Individual
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Provider Name | SANDRA BLANDON NP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 235 PORT RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10302-1701
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Country | US
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Telephone | 718-876-1732
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Fax | 718-876-3459
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Provider Business Mailing Address
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Address Line | 235 PORT RICHMOND AVE SUITE 201
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City | STATEN ISLAND
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State | NY
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Zip | 10302-1701
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Country | US
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Telephone | 718-876-1732
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 334411
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License Number State | NY
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