Provider Demographics
NPI:1093194839
Name:CLINE, SARA CASEY (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:CASEY
Last Name:CLINE
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:UNION BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-2909
Mailing Address - Country:US
Mailing Address - Phone:908-510-7673
Mailing Address - Fax:
Practice Address - Street 1:550 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5901
Practice Address - Country:US
Practice Address - Phone:617-989-4260
Practice Address - Fax:617-989-4150
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA26052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer