Individual
DIANA R SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 E AND WEST RD, WEST SENECA, NY 14224-3602
(716) 674-9730
Mailing address
1010 E AND WEST RD, WEST SENECA, NY 14224-3602
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
201554
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201554
—
NY
Enumeration date
03/20/2007
Last updated
07/08/2007
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