Healthcare Provider Details
I. General information
NPI: 1629918958
Provider Name (Legal Business Name): SIERRA OKEEFE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
81 WASHINGTON AVE
NORTH HAVEN CT
06473-1704
US
IV. Provider business mailing address
81 WASHINGTON AVE
NORTH HAVEN CT
06473-1704
US
V. Phone/Fax
- Phone: 203-985-9000
- Fax:
- Phone: 203-985-9000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: