Individual
MRS. SANDRA BOEBEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7353 NY ROUTE 96, VICTOR, NY 14564-1456
(585) 337-0817
Mailing address
150 ADELAIDE AVE, CANANDAIGUA, NY 14424-1502
(585) 329-3179
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401700-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03931202
—
NY
01
—
F401700-1
NP LICENSE
NY
Enumeration date
06/19/2014
Last updated
12/30/2019
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