Provider Demographics
NPI:1043380876
Name:JOSEPH B SAPPINGTON MD FACC PC
Entity Type:Organization
Organization Name:JOSEPH B SAPPINGTON MD FACC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:B
Authorized Official - Last Name:SAPPINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACC PC
Authorized Official - Phone:860-525-7357
Mailing Address - Street 1:300 HEBRON AVENUE
Mailing Address - Street 2:SUITE 213
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2192
Mailing Address - Country:US
Mailing Address - Phone:860-525-7357
Mailing Address - Fax:860-293-0255
Practice Address - Street 1:300 HEBRON AVE
Practice Address - Street 2:SUITE 213
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2176
Practice Address - Country:US
Practice Address - Phone:860-525-7357
Practice Address - Fax:860-293-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004395168Medicaid
CT004395168Medicaid