Provider Demographics
NPI:1255322889
Name:SAROFEEN, LOUISE (MS PT)
Entity type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:
Last Name:SAROFEEN
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:MISS
Other - First Name:LOUISE
Other - Middle Name:
Other - Last Name:FULLERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS PT
Mailing Address - Street 1:40 BEACH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MANCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01944-1468
Mailing Address - Country:US
Mailing Address - Phone:978-526-8288
Mailing Address - Fax:978-526-7084
Practice Address - Street 1:40 BEACH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MANCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01944-1468
Practice Address - Country:US
Practice Address - Phone:978-526-8288
Practice Address - Fax:978-526-7084
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA161752251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY68995Medicare ID - Type UnspecifiedPHYSICAL THERAPIST