Provider Demographics
NPI:1003455080
Name:CANTERMAN, SARAH (RDN, CSP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CANTERMAN
Suffix:
Gender:F
Credentials:RDN, CSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 SURREY ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2635
Mailing Address - Country:US
Mailing Address - Phone:520-250-9009
Mailing Address - Fax:
Practice Address - Street 1:24 MYRTLE ST STE A
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6359
Practice Address - Country:US
Practice Address - Phone:520-250-9009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL86032376133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered