MEDICARE: SARAH A GROMKO MS, CCC-SLP, PAVA-RV

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	6315	CT

General Provider Information

NPI Number	:	1982185047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH A GROMKO MS, CCC-SLP, PAVA-RV

Provider Business Mailing Address
First Line	:	123 YORK ST STE 1C
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-5660
Country	:	US
Telephone Number	:	203-868-0767
Fax Number	:	203-290-1895

Provider Business Practice Location Address
First Line	:	123 YORK ST STE 1C
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-5660
Country	:	US
Telephone Number	:	203-868-0767
Fax Number	:	203-290-1895

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2018
Last Update Date	:	05/17/2026

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