Provider Demographics
NPI:1689477010
Name:SARAH BRENNER, LLC
Entity type:Organization
Organization Name:SARAH BRENNER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BRENNER
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:203-871-8214
Mailing Address - Street 1:240 SIDNEY ST UNIT 102
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4298
Mailing Address - Country:US
Mailing Address - Phone:203-871-8214
Mailing Address - Fax:
Practice Address - Street 1:240 SIDNEY ST UNIT 102
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4298
Practice Address - Country:US
Practice Address - Phone:203-871-8214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty