Provider Demographics
NPI:1528157849
Name:SAUNDERS, STEVEN A (PAC)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:A
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 KENT RD
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-3485
Mailing Address - Country:US
Mailing Address - Phone:860-355-8000
Mailing Address - Fax:860-350-6291
Practice Address - Street 1:131 KENT RD
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776
Practice Address - Country:US
Practice Address - Phone:860-355-8000
Practice Address - Fax:860-350-6291
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001188363A00000X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTQ69215Medicare UPIN
CT970002151Medicare ID - Type Unspecified