Basic Information
| Provider Information | |||||||||
| NPI: | 1093721698 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | O'CONNELL | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2006 | ||||||||
| LastUpdateDate: | 01/21/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 227792 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 042297845 | 01 | MA | UNICARE | OTHER | 042297845 | 01 | MA | HCVM | OTHER | AA68404 | 01 | MA | HARVARD PILGRIM | OTHER | P00378961 | 01 | MA | RR MEDICARE | OTHER | 042297845 | 01 | MA | UHC | OTHER | 042297845 | 01 | MA | GREAT WEST HEALTH CARE | OTHER | 1373215 | 01 | MA | AETNA - HMO | OTHER | A40755 | 01 | MA | MEDICARE | OTHER | 042297845 | 01 | MA | TRICARE | OTHER | 117605 | 01 | MA | FALLON | OTHER | 042297845 | 01 | MA | MULTI-PLAN | OTHER | 495243 | 01 | MA | TUFTS | OTHER | 7016805 | 01 | MA | AETNA - PPO | OTHER | 2128632 | 05 | MA | MEDICAID | J40787 | 01 | MA | BCBS | OTHER | 0447060 | 01 | MA | CIGNA | OTHER | 495243 | 01 | MA | TUFTS MEDICARE PREFERRED | OTHER | 0039272 | 01 | MA | NHP | OTHER |