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General NPI Number Information
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NPI Number | 1407834658
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Entity Type | Individual
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Provider Name | SARAH RACHEL DESMOND CPNP
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Gender | Female
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Dates
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Enumeration Date | 01/07/2006
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 632 BLUE HILL AVE HARVARD STREET NEIGHBORHOOD HEALTH CENTER
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City | DORCHESTER
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State | MA
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Zip | 02121-3213
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Country | US
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Telephone | 617-825-3400
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Fax | 617-825-8899
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Provider Business Mailing Address
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Address Line | 88 ARLINGTON ST
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City | HYDE PARK
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State | MA
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Zip | 02136-3004
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Country | US
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Telephone | 857-345-9136
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Fax | 857-345-9136
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 204400
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License Number State | MA
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