Provider Demographics
NPI:1922035757
Name:SPARROW, SARAH (ATC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SPARROW
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HAYNES RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4407
Mailing Address - Country:US
Mailing Address - Phone:617-224-8050
Mailing Address - Fax:
Practice Address - Street 1:915 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1394
Practice Address - Country:US
Practice Address - Phone:617-353-1595
Practice Address - Fax:617-358-3747
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16282255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer