Healthcare Provider Details

I. General information

NPI: 1669761722
Provider Name (Legal Business Name): SARAH H O'CONNELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 CRESCENT ST
MIDDLETOWN CT
06457-3654
US

IV. Provider business mailing address

PO BOX 411034
BOSTON MA
02241-1034
US

V. Phone/Fax

Practice location:
  • Phone: 860-358-6071
  • Fax:
Mailing address:
  • Phone: 814-426-7317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number9584BP1-0037436
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number54291
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: