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Provider Information for 1437612793


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Dr. ROBERTA NANA ENYIMA BAAH-SACKEY MD


Sex: Female

NPI: 1437612793
Last Updated: 2022-08-23
Certification Date: 2022-08-23

Details

NameValue
NPI1437612793
Enumeration Date2019-04-12
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 263 FARMINGTON AVE
FARMINGTON, CT 06030-8082
United States

Phone: 860-679-4477 | Fax:860-679-1025
 
Primary Practice Address 263 FARMINGTON AVE
FARMINGTON, CT 06030-8021
United States

Phone: 860-679-4477 | Fax:860-679-1025
 
Secondary Practice Address(es)

79 RETREAT AVE
HARTFORD, CT 06106-2527
United States

Phone: 860-972-0200 | Fax:860-545-3149
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 390200000X - Student in an Organized Health Care Education/Training Program
Yes 207R00000X - Internal Medicine CT071525