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Contact Information

SARA E MACDONOUGH CIVITELLO, ATC, LAT
275 MOUNT CARMEL AVE
HAMDEN, CT06518-1908
 Phone: 203-582-8941
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for SARA E MACDONOUGH CIVITELLO · (Female)

NPI # 1801538368
Status Active
Credentials ATC, LAT
Entity Individual
Enumeration date 04/13/2022
Last updated 04/13/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CT License # 000629
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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