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General NPI Number Information
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NPI Number | 1467034850
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Entity Type | Individual
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Provider Name | WILSON STEVEN SANGO DO
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Gender | Male
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Dates
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Enumeration Date | 04/25/2021
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 100 GRAND ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-2016
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Country | US
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Telephone | 860-224-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 263 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06030-0001
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Country | US
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Telephone | 860-679-2147
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Fax | 860-679-4624
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 1021060
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 78885
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License Number State | CT
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