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
Certification Date: 2022-08-23
Details
Name | Value | ||||||||||||
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NPI | 1437612793 | ||||||||||||
Enumeration Date | 2019-04-12 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | NO | ||||||||||||
Status | Active | ||||||||||||
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 | ||||||||||||
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