Provider Demographics
NPI:1932195401
Name:SANDIFER, EILEEN (CRNP)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:SANDIFER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 EASTON RD
Mailing Address - Street 2:STE 2500
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2906
Mailing Address - Country:US
Mailing Address - Phone:215-918-5775
Mailing Address - Fax:215-918-5776
Practice Address - Street 1:847 EASTON RD
Practice Address - Street 2:STE 2500
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2906
Practice Address - Country:US
Practice Address - Phone:215-918-5775
Practice Address - Fax:215-918-5776
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP003256D208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAVP003256DOtherMEDICAL LICENSE