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General NPI Number Information
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NPI Number | 1134573066
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Entity Type | Individual
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Provider Name | ASHLEY SANDIFORD
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Gender | Female
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 04/18/2016
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Provider Practice Location Address
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Address Line | 204 GREAT EAST NECK RD
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City | WEST BABYLON
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State | NY
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Zip | 11704-7821
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Country | US
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Telephone | 631-422-7282
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Fax |
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Provider Business Mailing Address
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Address Line | 191 CANDLEWOOD RD
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City | BAY SHORE
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State | NY
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Zip | 11706-2214
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Country | US
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Telephone | 631-398-4752
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 061439
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License Number State | NY
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