Healthcare Provider Details

I. General information

NPI: 1366905598
Provider Name (Legal Business Name): SEAN PATTERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2019
Last Update Date: 04/19/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 LIBERTY ST
NEW HAVEN CT
06519-1625
US

IV. Provider business mailing address

184 LIBERTY ST
NEW HAVEN CT
06519-1625
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-9791
  • Fax: 203-688-9744
Mailing address:
  • Phone: 203-688-9791
  • Fax: 203-688-9744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number68809
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: