Individual
SANDRA K ANTONIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3500 N SABINO CANYON RD UNIT 54, TUCSON, AZ 85750-6141
(402) 305-1921
Mailing address
3500 N SABINO CANYON RD UNIT 54, TUCSON, AZ 85750-6141
(402) 305-1921
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
266006
NY
2084P0800X
Psychiatry Physician
Primary
266006
NY
2084P0804X
Child & Adolescent Psychiatry Physician
266006
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03615758
—
NY
01
—
266006
LICENSE
NY
Enumeration date
06/28/2007
Last updated
12/03/2021
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