Provider Demographics
NPI:1841223484
Name:SARRACINO, JOANNA LUMBA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:LUMBA
Last Name:SARRACINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOANNA
Other - Middle Name:DONATO
Other - Last Name:SARRACINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2371 BLACK ROCK TPKE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3229
Mailing Address - Country:US
Mailing Address - Phone:203-371-0141
Mailing Address - Fax:203-371-0141
Practice Address - Street 1:2371 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3229
Practice Address - Country:US
Practice Address - Phone:203-371-0141
Practice Address - Fax:203-371-0141
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049509207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I06856Medicare UPIN
CA106856Medicare UPIN