Provider Demographics
NPI:1780189092
Name:FIALLO, SARAH CAROL (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:CAROL
Last Name:FIALLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:CAROL
Other - Last Name:LALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 EMBARCADERO CTR STE 1900
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3723
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:
Practice Address - Street 1:20 ELM ST
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3305
Practice Address - Country:US
Practice Address - Phone:888-663-6331
Practice Address - Fax:203-604-1053
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312916207Q00000X
CT69293207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine