MEDICARE: SARA L CHETKIN M.D.

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	171100000X	Acupuncturist	233818	MA

General Provider Information

NPI Number	:	1295985224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA L CHETKIN M.D.

Provider Business Mailing Address
First Line	:	3410 WERNER AVE
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78722-2248
Country	:	US
Telephone Number	:	617-794-3740
Fax Number	:

Provider Business Practice Location Address
First Line	:	1211 BAYLOR ST
Second Line	:	SUITE 100
City	:	AUSTIN
State	:	TX
Zip	:	78703-4104
Country	:	US
Telephone Number	:	617-794-3740
Fax Number	:

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

Provider Enumeration Date	:	09/26/2008
Last Update Date	:	09/26/2008

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