MEDICARE: STEPHANIE SANZ

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1255854881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE SANZ

Provider Business Mailing Address
First Line	:	7610 34TH AVE APT 2K
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-2242
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	252 JAVA ST STE 334
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11222-5558
Country	:	US
Telephone Number	:	415-794-9730
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2017
Last Update Date	:	07/25/2017

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Directions to “ STEPHANIE SANZ ” Practice Location

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