Individual
ELISABETH SANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17511 144TH DR, JAMAICA, NY 11434-4930
(917) 406-4154
Mailing address
17511 144TH DR, JAMAICA, NY 11434-4930
(917) 406-4154
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
351613
NY
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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