Provider Demographics
NPI:1689226664
Name:MAURER, SARAH ELIZABETH (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:MAURER
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 BEDFORD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3508
Mailing Address - Country:US
Mailing Address - Phone:317-695-7285
Mailing Address - Fax:
Practice Address - Street 1:142 BERKELEY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5100
Practice Address - Country:US
Practice Address - Phone:617-247-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4272133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered