Provider Demographics
NPI:1740530880
Name:GOLDMAN-SMITH, SARAH M (PT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:GOLDMAN-SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1133
Mailing Address - Country:US
Mailing Address - Phone:508-328-0594
Mailing Address - Fax:
Practice Address - Street 1:67 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:WEST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02379-1133
Practice Address - Country:US
Practice Address - Phone:508-328-0594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13316225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist