MEDICARE: DANA JILL SAWITZ

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1508114240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA JILL SAWITZ

Provider Business Mailing Address
First Line	:	780 AMERICAN LEGION HWY
Second Line	:
City	:	ROSLINDALE
State	:	MA
Zip	:	02131-3908
Country	:	US
Telephone Number	:	617-469-8565
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 STATEN RD
Second Line	:
City	:	BRAINTREE
State	:	MA
Zip	:	02184-3118
Country	:	US
Telephone Number	:	845-401-2529
Fax Number	:

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

Provider Enumeration Date	:	08/28/2012
Last Update Date	:	09/20/2012

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