Provider Demographics
NPI:1194086017
Name:SANDERS, KATHRYN HELEN
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:HELEN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:HELEN
Other - Last Name:BELLEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED
Mailing Address - Street 1:503 E 13TH ST APT G2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-3577
Mailing Address - Country:US
Mailing Address - Phone:917-251-5613
Mailing Address - Fax:
Practice Address - Street 1:503 E 13TH ST APT G2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-3577
Practice Address - Country:US
Practice Address - Phone:917-251-5613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist