Provider Demographics
NPI:1649586108
Name:PARROW, SANDRA J
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:J
Last Name:PARROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:NY
Mailing Address - Zip Code:13646-3201
Mailing Address - Country:US
Mailing Address - Phone:315-778-9814
Mailing Address - Fax:
Practice Address - Street 1:58 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:NY
Practice Address - Zip Code:13646-3201
Practice Address - Country:US
Practice Address - Phone:315-778-9814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253397164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse