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NPI Code Detail

MEDICARE: REBECCA SANGER ATC

MEDICARE:   REBECCA  SANGER  ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic TrainerAT546ME
22255A2300XAthletic Trainer002526-1NY

General Provider Information

NPI Number : 1154790426
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA SANGER ATC
Provider Business Mailing Address
First Line : 1400 WASHINGTON AVE
Second Line :
City : ALBANY
State : NY
Zip : 12222-0100
Country : US
Telephone Number : 518-591-8532
Fax Number : 518-437-4450
Provider Business Practice Location Address
First Line : 1400 WASHINGTON AVE
Second Line :
City : ALBANY
State : NY
Zip : 12222-0100
Country : US
Telephone Number : 518-591-8532
Fax Number : 518-437-4450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2015
Last Update Date : 05/08/2018

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Directions to “ REBECCA SANGER ATC” Practice Location

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