Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 7221 | CT |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 7221 | CT |
NPI | 1790297240 |
---|---|
Provider Name | Mrs. Sarah Ashton Sanford |
First Address | Glastonbury, CT 06033-2410 |
Second Address | West Hartford, CT 06117-2508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2017 |
Last Update Date | 13/01/2022 |