Healthcare Provider Details
I. General information
NPI: 1992368997
Provider Name (Legal Business Name): PURPLE CRAYON PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2019
Last Update Date: 07/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22 MILL ST STE 206
ARLINGTON MA
02476-4738
US
IV. Provider business mailing address
22 MILL ST STE 206
ARLINGTON MA
02476-4738
US
V. Phone/Fax
- Phone: 781-867-9220
- Fax: 781-530-4440
- Phone: 781-867-9220
- Fax: 781-530-4440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SARAH
B.
SHELDON
Title or Position: PHYSICIAN/ OWNER
Credential: MD
Phone: 781-312-8436