Avis A Sanderson

Primary specialty

SpecialistTaxonomy code 174400000X

License

1347674192 Issued in NY

Practice address

1 Pierre Point Plaza
Brooklyn, NY 11201

Phone

(718) 576-3950

Fax

(718) 576-3539

NPI assigned

Sep 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1396394524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 FOUNTAIN AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112082516",
            "telephone_number": "718-576-3950",
            "fax_number": "718-576-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PIERRE POINT PLAZA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11201",
            "telephone_number": "718-576-3950",
            "fax_number": "718-576-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "AVIS",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1347674192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE DRIVERS LICENSE",
            "identifier": "829760448",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marvin Sanders, M.D.
• Nina Ellen Sanders, LCSW
• Samira Sanders
• Tanisha R Sanders, LCSW
• Vivian Sanders
• Dian Sanderson
• Kalliope Sky Sanderson, LCSW
• Natalia Sanderson
• Shirley Sanderson
• Alice J Sandgrund, PHD

• Specialist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.