Healthcare Provider Details

I. General information

NPI: 1437390168
Provider Name (Legal Business Name): SARA ELIZABETH GARBIN RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARA ELIZABETH HENRY RD

II. Dates (important events)

Enumeration Date: 03/09/2009
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 FILLOW ST UNIT 14
NORWALK CT
06850-2439
US

IV. Provider business mailing address

130 FILLOW ST UNIT 14
NORWALK CT
06850-2439
US

V. Phone/Fax

Practice location:
  • Phone: 203-449-6533
  • Fax:
Mailing address:
  • Phone: 203-449-6533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: