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General NPI Number Information
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NPI Number | 1285034819
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Entity Type | Organization
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Legal Business Name | RENATA SANDERS MD PLLC
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Dates
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Enumeration Date | 09/02/2014
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Last Update Date | 09/02/2014
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Provider Practice Location Address
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Address Line | 445 CENTRAL AVE SUITE 331
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City | CEDARHURST
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State | NY
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Zip | 11516-2001
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Country | US
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Telephone | 917-355-0312
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Fax |
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Provider Business Mailing Address
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Address Line | 445 CENTRAL AVE SUITE 331
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City | CEDARHURST
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State | NY
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Zip | 11516-2001
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Country | US
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Telephone | 917-355-0312
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Fax |
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Authorized Official
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Title or Position | MD
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Name | RENATA SANDERS
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Credential |
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Telephone | 917-355-0312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 264276
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License Number State | NY
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