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General NPI Number Information
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NPI Number | 1609881432
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Entity Type | Individual
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Provider Name | SANDRA THORNTON CONGDON MD
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Gender | Female
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 112 QUARRY RD 3RD FLOOR
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City | TRUMBULL
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State | CT
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Zip | 06611-4816
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Country | US
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Telephone | 203-374-1515
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Fax | 203-374-4702
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Provider Business Mailing Address
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Address Line | PO BOX 26899
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City | NEW YORK
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State | NY
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Zip | 10087-6899
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Country | US
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Telephone | 800-276-6531
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 029698
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License Number State | CT
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