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Individual
SARA ELIZABETH MACDONOUGH-CIVITELLO
Active
Individual
SARA ELIZABETH MACDONOUGH-CIVITELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
000629
CT
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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