Provider Demographics
NPI:1063732519
Name:PEINS, SANDRA A (RDMS)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:A
Last Name:PEINS
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 DERRY DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3550
Mailing Address - Country:US
Mailing Address - Phone:732-551-1999
Mailing Address - Fax:
Practice Address - Street 1:875 DERRY DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3550
Practice Address - Country:US
Practice Address - Phone:732-551-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2722591420002471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography