MEDICARE: SARA ELIZABETH GROSSLEIN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1003486499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA ELIZABETH GROSSLEIN PA

Provider Business Mailing Address
First Line	:	55 FRUIT ST DEPT OF
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02114-2621
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 FRUIT STREET
Second Line	:	WHITE 1
City	:	BOSTON
State	:	MA
Zip	:	02114-6110
Country	:	US
Telephone Number	:	617-724-4100
Fax Number	:	617-726-7415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2021
Last Update Date	:	05/01/2024

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Directions to “ SARA ELIZABETH GROSSLEIN PA” Practice Location

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