Individual
DR. SANDRA I TANDECIARZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
115 PARK ST SE, SUITE 300, VIENNA, VA 22180-4653
(703) 255-9100
(703) 255-3457
Mailing address
115 PARK ST SE, SUITE 300, VIENNA, VA 22180-4653
(703) 255-9100
(703) 255-3457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101052988
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05645913
—
VA
Enumeration date
09/01/2005
Last updated
11/27/2023
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