Healthcare Provider Details

I. General information

NPI: 1033991674
Provider Name (Legal Business Name): AMELIA SANCHEZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 PECK RD
TORRINGTON CT
06790-6107
US

IV. Provider business mailing address

52 PECK RD
TORRINGTON CT
06790-6107
US

V. Phone/Fax

Practice location:
  • Phone: 860-489-6899
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12442
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: