Provider Demographics
NPI:1699914697
Name:DR. SANDRA BWINT
Entity type:Organization
Organization Name:DR. SANDRA BWINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMERIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BWINT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-429-6930
Mailing Address - Street 1:206 KINGS HWY E
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1905
Mailing Address - Country:US
Mailing Address - Phone:856-429-6930
Mailing Address - Fax:856-429-6930
Practice Address - Street 1:206 KINGS HWY E
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1905
Practice Address - Country:US
Practice Address - Phone:856-429-6930
Practice Address - Fax:856-429-6930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27TO00005600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty