Individual
TIFFANY SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1253
(203) 709-6000
Mailing address
PO BOX 4523, DANBURY, CT 06813-4523
(203) 837-6658
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
291418
NY
207R00000X
Internal Medicine Physician
Primary
48976
CT
207R00000X
Internal Medicine Physician
D0061586
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008023910
—
CT
01
—
01011819
COVENTRY
CT
01
—
048976
CONNECTICARE
CT
01
—
582171
WELLCARE
CT
01
—
7472715
AETNA
CT
01
—
PENDING
RR MEDICARE
CT
Enumeration date
08/15/2005
Last updated
03/17/2018
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