Healthcare Provider Details

I. General information

NPI: 1982185047
Provider Name (Legal Business Name): SARAH A GROMKO MS, CCC-SLP, PAVA-RV
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 YORK ST STE 1C
NEW HAVEN CT
06511-5660
US

IV. Provider business mailing address

123 YORK ST STE 1C
NEW HAVEN CT
06511-5660
US

V. Phone/Fax

Practice location:
  • Phone: 203-868-0767
  • Fax: 203-290-1895
Mailing address:
  • Phone: 203-868-0767
  • Fax: 203-290-1895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6315
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: