Provider Demographics
NPI:1700574720
Name:ANASTASIO, SARAH (PEER SPECIALIST)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ANASTASIO
Suffix:
Gender:F
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W SQUANTUM ST STE 8
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2158
Mailing Address - Country:US
Mailing Address - Phone:617-910-6639
Mailing Address - Fax:
Practice Address - Street 1:110 W SQUANTUM ST STE 8
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2158
Practice Address - Country:US
Practice Address - Phone:617-910-6639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS04408544175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist