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NPI Code Detail

MEDICARE: SANITAS OF CONNECTICUT LLC

MEDICARE: SANITAS OF CONNECTICUT LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1497244321
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANITAS OF CONNECTICUT LLC
Provider Business Mailing Address
First Line : 4551 MAIN ST
Second Line :
City : BRIDGEPORT
State : CT
Zip : 06606-1818
Country : US
Telephone Number : 203-290-3800
Fax Number :
Provider Business Practice Location Address
First Line : 4551 MAIN ST
Second Line :
City : BRIDGEPORT
State : CT
Zip : 06606-1818
Country : US
Telephone Number : 203-290-3800
Fax Number :
Authorized Official
Title or Position : CFO
Name : ALBERTO DARSA
Credential :
Telephone Number : 305-470-2948
Provider Enumeration Date : 05/07/2018
Last Update Date : 05/07/2018

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Directions to “SANITAS OF CONNECTICUT LLC ” Practice Location

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