Individual
SYBIL LEE SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
44 DALE RD, PRIME HEALTHCARE, AVON, CT 06001-3612
(860) 674-8830
(860) 674-8984
Mailing address
30 JORDAN LN, PRIME HEALTHCARE, WETHERSFIELD, CT 06109-1278
(860) 263-0253
(860) 263-0262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
032256
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010032256CT03
BCBS
CT
01
—
032256
MEDICAL LICENSE
CT
Enumeration date
12/23/2005
Last updated
03/07/2023
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