Healthcare Provider Details

I. General information

NPI: 1265687073
Provider Name (Legal Business Name): SARAH ANDERSON RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

273 COUNTY RD
NEW LONDON NH
03257-5736
US

IV. Provider business mailing address

249 COUNTY RD
NEW LONDON NH
03257-5795
US

V. Phone/Fax

Practice location:
  • Phone: 603-526-5544
  • Fax:
Mailing address:
  • Phone: 603-526-2911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number259
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: