Provider Demographics
NPI:1336450261
Name:SARASIN, MATTHEW DANA (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DANA
Last Name:SARASIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CASS AVE
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-4731
Mailing Address - Country:US
Mailing Address - Phone:401-769-4100
Mailing Address - Fax:401-767-1667
Practice Address - Street 1:115 CASS AVE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4731
Practice Address - Country:US
Practice Address - Phone:401-769-4100
Practice Address - Fax:401-767-1667
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD14202207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program