Provider Demographics
NPI:1669001145
Name:KLEVEN, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KLEVEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:863 N MAIN STREET EXT STE 301
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2434
Mailing Address - Country:US
Mailing Address - Phone:203-269-0885
Mailing Address - Fax:
Practice Address - Street 1:863 N MAIN STREET EXT STE 301
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2434
Practice Address - Country:US
Practice Address - Phone:203-269-0885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1.078856207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology