Individual
SANDRA JACQUELINE LANDIVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
170 WASHINGTON BLVD, STAMFORD, CT 06902-8904
(203) 276-2472
(203) 276-4594
Mailing address
170 WASHINGTON BLVD, STAMFORD, CT 06902-8904
(203) 276-2472
(203) 276-4594
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
10436
CT
Other
Enumeration date
11/26/2020
Last updated
06/28/2024
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