Provider Demographics
NPI:1568425171
Name:SANDLER, JEFFREY R (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:R
Last Name:SANDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4699 MAIN ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-1830
Mailing Address - Country:US
Mailing Address - Phone:303-374-8182
Mailing Address - Fax:203-374-2626
Practice Address - Street 1:4699 MAIN ST
Practice Address - Street 2:SUITE 106
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-1830
Practice Address - Country:US
Practice Address - Phone:303-374-8182
Practice Address - Fax:203-374-2626
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT026266207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001262666Medicaid
CT001262666Medicaid
CTB39395Medicare UPIN