Basic Information
| Provider Information | |||||||||
| NPI: | 1134768435 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANDLER | ||||||||
| FirstName: | CHRISTIANNE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1258 MAYHEW TPKE | ||||||||
| Address2: | |||||||||
| City: | BRISTOL | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032225110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032542868 | ||||||||
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| Practice Location | |||||||||
| Address1: | 250 PLEASANT ST | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033017539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032252711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2020 | ||||||||
| LastUpdateDate: | 04/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.