Provider Demographics
NPI:1861690711
Name:MUCHNICK, SANDRA R (MED)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:R
Last Name:MUCHNICK
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 N BETHLEHEM PIKE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOWER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2655
Mailing Address - Country:US
Mailing Address - Phone:215-283-2833
Mailing Address - Fax:215-283-1919
Practice Address - Street 1:714 N BETHLEHEM PIKE
Practice Address - Street 2:SUITE 300
Practice Address - City:LOWER GWYNEDD
Practice Address - State:PA
Practice Address - Zip Code:19002-2655
Practice Address - Country:US
Practice Address - Phone:215-283-2833
Practice Address - Fax:215-283-1919
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist