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NPI Code Detail

MEDICARE: BRUCE TODD SANDERS M.D.

MEDICARE: BRUCE TODD SANDERS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician53918CT
2207Q00000XFamily Medicine Physician259019NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134429152
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE TODD SANDERS M.D.
Provider Business Mailing Address
First Line : 111 CLOCK TOWER CMNS
Second Line :
City : BREWSTER
State : NY
Zip : 10509-4055
Country : US
Telephone Number : 845-592-4915
Fax Number :
Provider Business Practice Location Address
First Line : 45 FOSTER RD
Second Line :
City : HOPEWELL JUNCTION
State : NY
Zip : 12533-6123
Country : US
Telephone Number : 845-226-4590
Fax Number : 845-226-2465
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2010
Last Update Date : 03/17/2018

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