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General NPI Number Information
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NPI Number | 1467426296
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Entity Type | Individual
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Provider Name | SANDRA H MALTZMAN NP
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Gender | Female
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Dates
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Enumeration Date | 02/16/2006
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 340 THOMPSON RD
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City | WEBSTER
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State | MA
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Zip | 01570-1509
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Country | US
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Telephone | 508-943-5132
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Fax | 508-943-5209
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Provider Business Mailing Address
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Address Line | PO BOX 40
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City | SOUTHBRIDGE
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State | MA
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Zip | 01550-0040
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Country | US
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Telephone | 508-909-7799
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Fax | 508-909-7750
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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 | 226285
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License Number State | MA
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