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Individual

DR. JEFFREY ROBERT SANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4 PARK LANE, NEW MILFORD, CT 06776
(860) 354-2241
(860) 350-8660
Mailing address
4 PARK LANE, NEW MILFORD, CT 06776
(860) 354-2241
(860) 350-8660

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
24946
CT
2086S0129X
Vascular Surgery Physician
24946
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001249465
CT
01
010024946CT02
BLUE SHEILD
CT
01
041378
HEALTHNET
01
2043999
AETNA
01
2248667002
CIGNA
01
500HBC186CT01
BLUE CARE FAMILY PLAN
01
56010024946CT2
ANTHEM NATIONAL ACCOUNT
01
706114
CONNECTICARE
01
LIS011
OXFORD
Enumeration date
09/01/2006
Last updated
03/14/2012
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