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NPI Code Detail

MEDICARE: DR. SARAH STEWART PSY.D.

MEDICARE: DR. SARAH STEWART PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistMA6317MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1W05021OTHERMABCBS PROVIDER NUMBER

General Provider Information

NPI Number : 1063579530
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SARAH STEWART PSY.D.
Provider Business Mailing Address
First Line : 263 CONCORD AVE
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-1336
Country : US
Telephone Number : 617-876-6735
Fax Number :
Provider Business Practice Location Address
First Line : 263 CONCORD AVE
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-1336
Country : US
Telephone Number : 617-876-6735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 07/08/2007

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