Active NPI
Dian Sanderson
- Family Nurse Practitioner
- Brooklyn, NY
National Provider Identifier
1275089666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F340966-1
- Practice address
- 2960 Ocean Ave
6TH Floor
Brooklyn, NY 11235-3202 - Phone
- (718) 336-5123
- NPI assigned
- Aug 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F340966-1 | NY | Primary |
Addresses
Primary practice location
2960 Ocean Ave
6TH Floor
Brooklyn, NY 11235-3202
Mailing address
570 W 204TH St
New York, NY 10034-4008
Phone (718) 336-5123
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F340966-1 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472169600000",
"number": "1275089666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "570 W 204TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100344008",
"telephone_number": "718-336-5123",
"fax_number": "718-336-5137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2960 OCEAN AVE",
"address_2": "6TH FLOOR",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112353202",
"telephone_number": "718-336-5123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERSON",
"first_name": "DIAN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-26",
"last_updated": "2016-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F340966-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.