Provider Demographics
NPI:1295471654
Name:MOURANI, SARA KATHERINE (MD)
Entity type:Individual
Prefix:MS
First Name:SARA KATHERINE
Middle Name:
Last Name:MOURANI
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 1:34 PARK ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1109
Mailing Address - Country:US
Mailing Address - Phone:786-820-4573
Mailing Address - Fax:305-355-7324
Practice Address - Street 1:34 PARK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1109
Practice Address - Country:US
Practice Address - Phone:786-820-4573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2025-06-03
Deactivation Date:2022-12-19
Deactivation Code:
Reactivation Date:2022-12-22
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLTRN36222390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program