Provider Demographics
NPI:1104089523
Name:DELAPORTA, SARA E (MD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:DELAPORTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:D
Other - Last Name:PASNAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2639 S COUNTY TRL
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1727
Mailing Address - Country:US
Mailing Address - Phone:401-400-2699
Mailing Address - Fax:401-406-2699
Practice Address - Street 1:2639 S COUNTY TRL
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1727
Practice Address - Country:US
Practice Address - Phone:401-400-2699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD13629207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RISD86250Medicaid