Healthcare Provider Details

I. General information

NPI: 1831364157
Provider Name (Legal Business Name): CHERYL ELIZABETH ANDERSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
LEBANON NH
03756-1000
US

IV. Provider business mailing address

1450 CHAPEL ST
NEW HAVEN CT
06511-4405
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-5000
  • Fax: 603-640-1228
Mailing address:
  • Phone: 203-789-3661
  • Fax: 203-789-4037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number50093
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: