Provider Demographics
NPI:1255480588
Name:PANARELLO, SARA ROSA (DC)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:ROSA
Last Name:PANARELLO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 STATION AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 NAHANT ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-3221
Practice Address - Country:US
Practice Address - Phone:781-259-8990
Practice Address - Fax:781-259-0738
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36674OtherBLUE CROSS BLUE SHIELD
MAY45282Medicare ID - Type Unspecified
MAU78288Medicare UPIN