Provider Demographics
NPI:1639275936
Name:CARRINGTON, SALLIE ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:SALLIE
Middle Name:ANN
Last Name:CARRINGTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:714 CHASE PARKWAY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3939
Mailing Address - Country:US
Mailing Address - Phone:203-755-4577
Mailing Address - Fax:213-756-3628
Practice Address - Street 1:70 HEMINWAY PARK RD
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-2612
Practice Address - Country:US
Practice Address - Phone:203-709-5925
Practice Address - Fax:203-709-5934
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT423207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001004231Medicaid
040000423CT03OtherBCBS
040000423CT03OtherBCBS
CT001004231Medicaid