Healthcare Provider Details

I. General information

NPI: 1255344198
Provider Name (Legal Business Name): SANDRA MINI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/21/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 POST RD WEST GROUND FLOOR
WESTPORT CT
06880-4754
US

IV. Provider business mailing address

333 POST RD WEST GROUND FLOOR
WESTPORT CT
06880-4754
US

V. Phone/Fax

Practice location:
  • Phone: 203-571-3000
  • Fax: 203-349-8179
Mailing address:
  • Phone: 203-571-3000
  • Fax: 203-349-8179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number044495
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number044495
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: