Provider Demographics
NPI:1740239383
Name:SARTANOWICZ, DIANE (ATC, LAT)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:
Last Name:SARTANOWICZ
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MANSFIELD ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6437
Mailing Address - Country:US
Mailing Address - Phone:508-620-5442
Mailing Address - Fax:
Practice Address - Street 1:250 WALTHAM ST
Practice Address - Street 2:
Practice Address - City:WEST NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-1749
Practice Address - Country:US
Practice Address - Phone:617-928-8870
Practice Address - Fax:617-630-2374
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer