Provider Demographics
NPI:1043560923
Name:TOMMASO, SARAH (OT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:TOMMASO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 POST RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6038
Mailing Address - Country:US
Mailing Address - Phone:203-949-9337
Mailing Address - Fax:203-254-3790
Practice Address - Street 1:101 N PLAINS INDUSTRIAL RD
Practice Address - Street 2:BUILDING 2
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2360
Practice Address - Country:US
Practice Address - Phone:203-949-9337
Practice Address - Fax:203-254-3790
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004512225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics