Provider Demographics
NPI:1790297240
Name:SANFORD, SARAH ASHTON (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ASHTON
Last Name:SANFORD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:676 HEBRON AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2410
Mailing Address - Country:US
Mailing Address - Phone:860-508-4570
Mailing Address - Fax:860-508-4570
Practice Address - Street 1:345 N MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2508
Practice Address - Country:US
Practice Address - Phone:860-586-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7221363LF0000X, 207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck