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General NPI Number Information
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NPI Number | 1881696367
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Entity Type | Individual
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Provider Name | MARILYN R SANDERS MD
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Gender | Female
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 282 WASHINGTON
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City | HARTFORD
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State | CT
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Zip | 06106
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Country | US
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Telephone | 860-545-8950
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Fax | 860-545-8945
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Provider Business Mailing Address
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Address Line | 282 WASHINGTON ST
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City | HARTFORD
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State | CT
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Zip | 06106-3322
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Country | US
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Telephone | 860-545-8592
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Fax | 860-545-9229
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 029783
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License Number State | CT
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