Healthcare Provider Details

I. General information

NPI: 1093065831
Provider Name (Legal Business Name): SARA QUINN BLACK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2012
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 BOSTON PROVIDENCE TPKE STE 8A
NORWOOD MA
02062-4946
US

IV. Provider business mailing address

12 JENNIFER LN
LAKEVILLE MA
02347-1728
US

V. Phone/Fax

Practice location:
  • Phone: 781-829-3300
  • Fax:
Mailing address:
  • Phone: 508-558-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2347255
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: