Healthcare Provider Details

I. General information

NPI: 1780987974
Provider Name (Legal Business Name): SARAH A. LOWRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2010
Last Update Date: 12/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 COLONIAL DR
QUINCY MA
02169-1849
US

IV. Provider business mailing address

120 COLONIAL DR
QUINCY MA
02169-1849
US

V. Phone/Fax

Practice location:
  • Phone: 617-471-8400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberS51960297
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: