MEDICARE: TARA B SANFT 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	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	49004	CT
2	207RX0202X	Medical Oncology Physician	049004	CT

General Provider Information

NPI Number	:	1730374562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA B SANFT M.D.

Provider Business Mailing Address
First Line	:	1290 SILAS DEANE HWY
Second Line	:	HHC CVO
City	:	WETHERSFIELD
State	:	CT
Zip	:	06109-4337
Country	:	US
Telephone Number	:	860-972-5507
Fax Number	:	860-972-7040

Provider Business Practice Location Address
First Line	:	4185 BLACK ROCK TPKE STE 202
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06824-1841
Country	:	US
Telephone Number	:	203-255-4545
Fax Number	:	203-254-1191

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

Provider Enumeration Date	:	09/14/2007
Last Update Date	:	12/17/2025

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