Provider Demographics
NPI:1417245424
Name:HANSON, SARAH E (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:E
Last Name:HANSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2300 CROWN COLONY DR
Mailing Address - Street 2:STE 102
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-0902
Mailing Address - Country:US
Mailing Address - Phone:781-986-0990
Mailing Address - Fax:781-986-0991
Practice Address - Street 1:25 BRAINTREE HILL OFFICE PARK
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-8808
Practice Address - Country:US
Practice Address - Phone:781-848-7300
Practice Address - Fax:781-848-5678
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19620225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA002291901Medicare PIN