Provider Demographics
NPI:1255446134
Name:RIVARD, SARAH J (LO)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:J
Last Name:RIVARD
Suffix:
Gender:F
Credentials:LO
Other - Prefix:
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Mailing Address - Street 1:546 SO BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450
Mailing Address - Country:US
Mailing Address - Phone:203-235-2511
Mailing Address - Fax:203-639-0809
Practice Address - Street 1:325 HIGHLAND AV
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410
Practice Address - Country:US
Practice Address - Phone:203-271-3937
Practice Address - Fax:203-271-3937
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
0331140001Medicare ID - Type Unspecified