Provider Demographics
NPI:1154326833
Name:DAINIAK, SARAH G (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:G
Last Name:DAINIAK
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 1:445 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-1646
Mailing Address - Country:US
Mailing Address - Phone:860-561-7111
Mailing Address - Fax:860-561-7272
Practice Address - Street 1:445 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-1646
Practice Address - Country:US
Practice Address - Phone:860-561-7111
Practice Address - Fax:860-561-7272
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042088207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT11543268533Medicaid
I03748Medicare UPIN
CT11543268533Medicaid
P00470529Medicare PIN