Healthcare Provider Details

I. General information

NPI: 1326021890
Provider Name (Legal Business Name): SANDRA ANN SPRINGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 YORK ST NATHAN SMITH CLINIC
NEW HAVEN CT
06510-3221
US

IV. Provider business mailing address

1 LONG WHARF DR
NEW HAVEN CT
06511-5991
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-5303
  • Fax: 203-688-3216
Mailing address:
  • Phone: 203-781-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number040782
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number40782
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number40782
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: