Mampouya, Sandra B
Mampouya, Sandra B is an individual health care provider with primary practice located at 21468 Whitehall Ter , Queens Village NY 11427-1829. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mampouya, Sandra B can be contacted via phone (718) 740-0253.Contact Information
Primary practice address
21468 Whitehall Ter
Queens Village NY 11427-1829
Phone: (718) 740-0253
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 009842 | New York |
Profile Details
| NPI number | 1427159367 |
|---|---|
| LBN Legal business name | Mampouya, Sandra B |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 25th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427159367 | NPPES |
| New York | MEDICAID | 00246075 |
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