Healthcare Provider Details

I. General information

NPI: 1932236395
Provider Name (Legal Business Name): SARAH B GOLDBERG M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 CEDAR ST FMP-130
NEW HAVEN CT
06520-8032
US

IV. Provider business mailing address

333 CEDAR ST FMP-130, P.O. BOX 208032
NEW HAVEN CT
06520-8032
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-7564
  • Fax: 203-785-3788
Mailing address:
  • Phone: 203-785-7564
  • Fax: 203-785-3788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number51265
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number51265
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: