Provider Demographics
NPI:1710705819
Name:HADDAD, SARAH MARIE (PMHNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:HADDAD
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-0015
Mailing Address - Country:US
Mailing Address - Phone:475-422-5956
Mailing Address - Fax:
Practice Address - Street 1:220 5TH AVE
Practice Address - Street 2:11TH FLOOR, SUITE 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7708
Practice Address - Country:US
Practice Address - Phone:212-564-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-28
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT15193363LP0808X
NY407433363LP0808X
FLTPAN3824363LP0808X
CT174839163W00000X
NY808739163W00000X
NJ26NR27410500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse