Healthcare Provider Details

I. General information

NPI: 1720592231
Provider Name (Legal Business Name): JESSICA SARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2017
Last Update Date: 11/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2360 CRANBERRY HWY
WEST WAREHAM MA
02576-1208
US

IV. Provider business mailing address

PO BOX 284
WEST WAREHAM MA
02576-0284
US

V. Phone/Fax

Practice location:
  • Phone: 508-273-0190
  • Fax: 508-273-9943
Mailing address:
  • Phone: 508-273-0190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number23032
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: