Individual provider Active NPI

Sandra Lee Petronis, RN

  • Registered Nurse
  • Stratford, NJ
National Provider Identifier
1265757694
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
26NR09862000 Issued in NJ
Practice address
1 Colby Ave
Stratford, NJ 08084-1000
Phone
(856) 541-1700
Fax
(856) 346-3627
NPI assigned
Mar 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR09862000 NJ Primary

Addresses

Primary practice location

1 Colby Ave
Stratford, NJ 08084-1000

Mailing address

1 Colby Ave
Stratford, NJ 08084-1000
Phone (856) 541-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NR09862000NJMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1265757694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COLBY AVE",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841000",
            "telephone_number": "856-541-1700",
            "fax_number": "856-346-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLBY AVE",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841000",
            "telephone_number": "856-541-1700",
            "fax_number": "856-346-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRONIS",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR09862000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.