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NPI Code Detail

MEDICARE: MRS. SARAH RACHEL DESMOND CPNP

MEDICARE:  MRS. SARAH RACHEL DESMOND  CPNP
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
1363LP0200XPediatric Nurse Practitioner204400MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407834658
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SARAH RACHEL DESMOND CPNP
Provider Business Mailing Address
First Line : 88 ARLINGTON ST
Second Line :
City : HYDE PARK
State : MA
Zip : 02136-3004
Country : US
Telephone Number : 857-345-9136
Fax Number : 857-345-9136
Provider Business Practice Location Address
First Line : 632 BLUE HILL AVE
Second Line : HARVARD STREET NEIGHBORHOOD HEALTH CENTER
City : DORCHESTER
State : MA
Zip : 02121-3213
Country : US
Telephone Number : 617-825-3400
Fax Number : 617-825-8899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2006
Last Update Date : 03/14/2012

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Directions to “ MRS. SARAH RACHEL DESMOND CPNP” Practice Location

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