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NPI Code Detail

MEDICARE: ASSUNTA MARIA SANDOR P.A.

MEDICARE: ASSUNTA MARIA SANDOR P.A.
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
1363AM0700XMedical Physician Assistant001570CT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00451138OTHERCTRAILROADMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1290001570CT06OTHERCTANTHEM BCBS
3010570Q040OTHERCTCONNECTICARE
42V9259OTHERCTHEALTHNET

General Provider Information

NPI Number : 1578607727
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASSUNTA MARIA SANDOR P.A.
Provider Business Mailing Address
First Line : 52 WASHINGTON AVE
Second Line : SUITE 4
City : NORTH HAVEN
State : CT
Zip : 06473-1724
Country : US
Telephone Number : 203-672-2800
Fax Number : 203-672-2801
Provider Business Practice Location Address
First Line : 52 WASHINGTON AVE
Second Line : SUITE 4
City : NORTH HAVEN
State : CT
Zip : 06473-1724
Country : US
Telephone Number : 203-672-2800
Fax Number : 203-672-2801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2007
Last Update Date : 10/28/2010

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Directions to “ ASSUNTA MARIA SANDOR P.A.” Practice Location

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