Healthcare Provider Details

I. General information

NPI: 1962437657
Provider Name (Legal Business Name): ERIN F SANZONE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1579 STRAITS TPKE STE E ORTHOPAEDICS NEW ENGLAND PC
MIDDLEBURY CT
06762-1835
US

IV. Provider business mailing address

1579 STRAITS TPKE STE E ORTHOPAEDICS NEW ENGLAND PC
MIDDLEBURY CT
06762-1835
US

V. Phone/Fax

Practice location:
  • Phone: 203-598-0700
  • Fax: 877-345-6922
Mailing address:
  • Phone: 203-598-0700
  • Fax: 877-345-6922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number000728
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: