Healthcare Provider Details

I. General information

NPI: 1194991802
Provider Name (Legal Business Name): SARAH SCHLEGEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS, 5G
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

282 WASHINGTON ST DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS, 5G
HARTFORD CT
06106-3322
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-8589
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number044739
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number044739
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: