Active NPI
Sandra M Condry, PHD
- Clinical Child & Adolescent Psychologist
- Freeville, NY
National Provider Identifier
1891709705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 009309-1
- Practice address
- 738 Sheldon Rd
Freeville, NY 13068-5714 - Phone
- (607) 898-5047
- Fax
- (607) 898-5047
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 009309-1 | NY | Primary |
Addresses
Primary practice location
738 Sheldon Rd
Freeville, NY 13068-5714
Mailing address
738 Sheldon Rd
Freeville, NY 13068-5714
Phone (607) 898-5047
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009309-1 | NY | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221523200000",
"number": "1891709705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "738 SHELDON RD",
"city": "FREEVILLE",
"state": "NY",
"postal_code": "130685714",
"telephone_number": "607-898-5047",
"fax_number": "607-898-5047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "738 SHELDON RD",
"city": "FREEVILLE",
"state": "NY",
"postal_code": "130685714",
"telephone_number": "607-898-5047",
"fax_number": "607-898-5047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONDRY",
"first_name": "SANDRA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2008-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NY",
"license": "009309-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Freeville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.