Individual
NICOLE A SANDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN-PMHNP
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 638-1575
Mailing address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 638-1575
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
660968
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401946
NY
Other
Enumeration date
08/28/2015
Last updated
05/24/2023
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