MEDICARE: DR. MARY CUMMINGS SATTI 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
1	207R00000X	Internal Medicine Physician	033112	CT

Other Identifiers

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

General Provider Information

NPI Number	:	1376540849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY CUMMINGS SATTI M.D.

Provider Business Mailing Address
First Line	:	8 VISTA DR
Second Line	:	EASTPORT NORTH BUSINESS PARK
City	:	OLD LYME
State	:	CT
Zip	:	06371-1537
Country	:	US
Telephone Number	:	860-434-8847
Fax Number	:	860-434-0428

Provider Business Practice Location Address
First Line	:	8 VISTA DR
Second Line	:	EASTPORT NORTH BUSINESS PARK
City	:	OLD LYME
State	:	CT
Zip	:	06371-1537
Country	:	US
Telephone Number	:	860-434-8847
Fax Number	:	860-434-0428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	04/24/2015

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