Provider Demographics
NPI:1417295106
Name:ANDREOZZI, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ANDREOZZI
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 1:4 SAGINAW AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1335
Mailing Address - Country:US
Mailing Address - Phone:401-829-7977
Mailing Address - Fax:
Practice Address - Street 1:21 WORTHEN RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-4835
Practice Address - Country:US
Practice Address - Phone:781-861-6340
Practice Address - Fax:781-541-5127
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA252237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1598891855Medicaid