Healthcare Provider Details

I. General information

NPI: 1386716694
Provider Name (Legal Business Name): BINDU SARA THOMAS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 STRAWBERRY HILL CT
STAMFORD CT
06902-2594
US

IV. Provider business mailing address

32 STRAWBERRY HILL CT
STAMFORD CT
06902-2594
US

V. Phone/Fax

Practice location:
  • Phone: 203-276-7298
  • Fax: 203-276-4842
Mailing address:
  • Phone: 203-276-7298
  • Fax: 203-276-4842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12057
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF333594-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: