1093721698 NPI number — SARAH J O'CONNELL M.D.

Table of content: SARAH J O'CONNELL M.D. (NPI 1093721698)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093721698 NPI number — SARAH J O'CONNELL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'CONNELL
Provider First Name:
SARAH
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093721698
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
56 NEW DRIFTWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCITUATE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02066-4533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
138-878-1544
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
56 NEW DRIFTWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCITUATE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02066-4533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-544-1388
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  227792 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7016805 . This is a "AETNA - PPO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "TRICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: A40755 . This is a "MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA68404 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "UNICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 495243 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0039272 . This is a "NHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "MULTI-PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0447060 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1373215 . This is a "AETNA - HMO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 117605 . This is a "FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 495243 . This is a "TUFTS MEDICARE PREFERRED" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: P00378961 . This is a "RR MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "GREAT WEST HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "UHC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "HCVM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2128632 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: J40787 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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