MEDICARE: MS. VANMALY K SANCHEZ APRN

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	363LP2300X	Primary Care Nurse Practitioner	6753	CT

General Provider Information

NPI Number	:	1548706153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VANMALY K SANCHEZ APRN

Provider Business Mailing Address
First Line	:	127 PINES BRIDGE ROAD
Second Line	:
City	:	BEACON FALLS
State	:	CT
Zip	:	06403-1017
Country	:	US
Telephone Number	:	203-881-2757
Fax Number	:

Provider Business Practice Location Address
First Line	:	127 PINES BRIDGE RD
Second Line	:
City	:	BEACON FALLS
State	:	CT
Zip	:	06403-1017
Country	:	US
Telephone Number	:	203-881-2757
Fax Number	:

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

Provider Enumeration Date	:	01/06/2017
Last Update Date	:	03/06/2017

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