Provider Demographics
NPI:1982225793
Name:DUFRESNE, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DUFRESNE
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 1:25 PURITAN AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-3291
Mailing Address - Country:US
Mailing Address - Phone:860-303-8526
Mailing Address - Fax:
Practice Address - Street 1:25 PURITAN AVE APT 2
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-3291
Practice Address - Country:US
Practice Address - Phone:860-303-8526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist