Provider Demographics
NPI:1104177971
Name:FORDE-CUFFIE, SADEE TRICIA (MD)
Entity Type:Individual
Prefix:
First Name:SADEE
Middle Name:TRICIA
Last Name:FORDE-CUFFIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SADEE
Other - Middle Name:
Other - Last Name:FORDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:761 MAIN AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1080
Mailing Address - Country:US
Mailing Address - Phone:203-838-4000
Mailing Address - Fax:203-845-9535
Practice Address - Street 1:761 MAIN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1080
Practice Address - Country:US
Practice Address - Phone:203-838-4000
Practice Address - Fax:203-845-9535
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT052477207R00000X
PA450064207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT052477OtherLICENSE