MEDICARE: SANDRA ANTHONY

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	163W00000X	Registered Nurse	825214	NY

General Provider Information

NPI Number	:	1780491704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA ANTHONY

Provider Business Mailing Address
First Line	:	787 E 46TH ST APT 1E
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5757
Country	:	US
Telephone Number	:	347-543-0899
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 47TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3433
Country	:	US
Telephone Number	:	347-396-8893
Fax Number	:

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

Provider Enumeration Date	:	12/12/2024
Last Update Date	:	12/12/2024

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Directions to “ SANDRA ANTHONY ” Practice Location

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