Provider Demographics
NPI:1366568313
Name:SANDLER, COLIN BRYNAN
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:BRYNAN
Last Name:SANDLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 PUTNAM RD
Mailing Address - Street 2:
Mailing Address - City:GARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10524-7447
Mailing Address - Country:US
Mailing Address - Phone:845-788-9114
Mailing Address - Fax:845-788-9114
Practice Address - Street 1:126 PUTNAM RD
Practice Address - Street 2:
Practice Address - City:GARRISON
Practice Address - State:NY
Practice Address - Zip Code:10524-7447
Practice Address - Country:US
Practice Address - Phone:845-788-9114
Practice Address - Fax:845-788-9114
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074287-1101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN4C741Medicare PIN