Healthcare Provider Details

I. General information

NPI: 1639332950
Provider Name (Legal Business Name): HEATHER ANN SANDERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER SANDERS DICAPRIO MD

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 02/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 ROCHESTER HILL RD UNIT 2
ROCHESTER NH
03867-1775
US

IV. Provider business mailing address

11 WHITEHALL RD
ROCHESTER NH
03867-3226
US

V. Phone/Fax

Practice location:
  • Phone: 603-332-0238
  • Fax: 603-332-7098
Mailing address:
  • Phone: 603-332-5211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35-095852
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15324
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: