Provider Demographics
NPI:1720592231
Name:SARRO, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SARRO
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:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:WEST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02576-0284
Mailing Address - Country:US
Mailing Address - Phone:508-273-0190
Mailing Address - Fax:
Practice Address - Street 1:2360 CRANBERRY HWY
Practice Address - Street 2:
Practice Address - City:WEST WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02576-1208
Practice Address - Country:US
Practice Address - Phone:508-273-0190
Practice Address - Fax:508-273-9943
Is Sole Proprietor?:No
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23032208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation