Provider Demographics
NPI:1871898908
Name:DEGEORGE, SANDRA NICOLE (CD(DONA), CLC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:NICOLE
Last Name:DEGEORGE
Suffix:
Gender:F
Credentials:CD(DONA), CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 CABRINI BLVD
Mailing Address - Street 2:SUITE 5D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1151
Mailing Address - Country:US
Mailing Address - Phone:917-623-7523
Mailing Address - Fax:
Practice Address - Street 1:250 CABRINI BLVD
Practice Address - Street 2:SUITE 5D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-1151
Practice Address - Country:US
Practice Address - Phone:917-623-7523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula