Provider Demographics
NPI:1093721698
Name:O'CONNELL, SARAH J (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 NEW DRIFTWAY
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-4533
Mailing Address - Country:US
Mailing Address - Phone:138-878-1544
Mailing Address - Fax:
Practice Address - Street 1:56 NEW DRIFTWAY
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-4533
Practice Address - Country:US
Practice Address - Phone:781-544-1388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7016805OtherAETNA - PPO
MA042297845OtherTRICARE
MAA40755OtherMEDICARE
MAAA68404OtherHARVARD PILGRIM
MA042297845OtherUNICARE
MA495243OtherTUFTS
MA0039272OtherNHP
MA042297845OtherMULTI-PLAN
MA0447060OtherCIGNA
MA1373215OtherAETNA - HMO
MA117605OtherFALLON
MA495243OtherTUFTS MEDICARE PREFERRED
MAP00378961OtherRR MEDICARE
MA042297845OtherGREAT WEST HEALTH CARE
MA042297845OtherUHC
MA042297845OtherHCVM
MA2128632Medicaid
MAJ40787OtherBCBS