Healthcare Provider Details

I. General information

NPI: 1235871765
Provider Name (Legal Business Name): SARAH ALLEN PICCONE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W MAIN ST STE 132
STAMFORD CT
06902-4544
US

IV. Provider business mailing address

2001 W MAIN ST STE 132
STAMFORD CT
06902-4544
US

V. Phone/Fax

Practice location:
  • Phone: 203-363-0123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number86276
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: