Provider Demographics
NPI:1487827374
Name:SANDERS, KARAINE L (PSYD)
Entity type:Individual
Prefix:DR
First Name:KARAINE
Middle Name:L
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11402 GUY R BREWER BLVD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-1234
Mailing Address - Country:US
Mailing Address - Phone:718-883-6652
Mailing Address - Fax:718-883-6669
Practice Address - Street 1:11402 GUY R BREWER BLVD
Practice Address - Street 2:SUITE 216
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-1234
Practice Address - Country:US
Practice Address - Phone:718-883-6652
Practice Address - Fax:718-883-6669
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent