Individual ProviderTiffany SandersInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address56 Franklin St, Waterbury, CT 06706-1253(203) 709-6000(203) 837-6658PECOS EnrollmentBased on the most recent information from CMS, provider Tiffany Sanders is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1508868944Provider TypeIndividualFull NameSanders, TiffanyCredentialMDGenderFemaleSole ProprietorNoEnumeration Date8/15/2005Last Updated3/17/2018Contact InformationPractice LocationPractice Address56 Franklin St, Waterbury, CT 06706-1253Phone(203) 709-6000FaxUnlisted FaxMailing LocationMailing AddressPO Box 4523, Danbury, CT 06813-4523Phone(203) 837-6658FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense48976ConnecticutCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseD0061586MarylandCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense291418New YorkProvider IdentifiersIDDescriptionIssuerID7472715DescriptionOtherIssuerAETNAConnecticutID008023910DescriptionMedicaidIssuerUnlistedConnecticutIDPENDINGDescriptionOtherIssuerRR MEDICAREConnecticutID048976DescriptionOtherIssuerCONNECTICAREConnecticutID01011819DescriptionOtherIssuerCOVENTRYConnecticutID582171DescriptionOtherIssuerWELLCAREConnecticut