Provider Demographics
NPI:1235828799
Name:LAURIANNO-FLANAGAN, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LAURIANNO-FLANAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W SQUANTUM ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2122
Mailing Address - Country:US
Mailing Address - Phone:617-997-6504
Mailing Address - Fax:
Practice Address - Street 1:110 W SQUANTUM ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2122
Practice Address - Country:US
Practice Address - Phone:617-997-6504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASA0431620175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist