Provider Demographics
NPI:1588654040
Name:CREMERS, SANDRA LORA (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LORA
Last Name:CREMERS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:243 CHARLES ST
Practice Address - Street 2:MASSACHUSETTS EYE AND EAR INFIRMARY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3002
Practice Address - Country:US
Practice Address - Phone:617-573-3529
Practice Address - Fax:617-573-3152
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2014-01-29
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Provider Licenses
StateLicense IDTaxonomies
MA203729207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA203729OtherTUFTS HEALTH PLAN