Healthcare Provider Details

I. General information

NPI: 1073921235
Provider Name (Legal Business Name): SARAH DELEHANTY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 09/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 GRANITE DR
BROOKFIELD CT
06804-1070
US

IV. Provider business mailing address

7 GRANITE DR
BROOKFIELD CT
06804-1070
US

V. Phone/Fax

Practice location:
  • Phone: 203-731-7258
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number045576011
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: