Healthcare Provider Details

I. General information

NPI: 1336225671
Provider Name (Legal Business Name): SARAH BAUM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2006
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 BARNES ROAD SUITE 6
WALLINGFORD CT
06492-1885
US

IV. Provider business mailing address

97 BARNES ROAD SUITE 6
WALLINGFORD CT
06492-1885
US

V. Phone/Fax

Practice location:
  • Phone: 203-265-9890
  • Fax: 203-265-3321
Mailing address:
  • Phone: 203-265-9890
  • Fax: 203-265-3321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number033108
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number033108
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: