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NPI Code Detail

MEDICARE: MS. SARAH RUTH THOENSEN

MEDICARE: MS. SARAH RUTH THOENSEN
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1790823938
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SARAH RUTH THOENSEN
Provider Business Mailing Address
First Line : 10 FAXON AVE
Second Line : APT 1002
City : QUINCY
State : MA
Zip : 02169-4682
Country : US
Telephone Number : 617-371-3010
Fax Number :
Provider Business Practice Location Address
First Line : 105 VICTORY RD
Second Line :
City : DORCHESTER
State : MA
Zip : 02122-3518
Country : US
Telephone Number : 617-371-3010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2007
Last Update Date : 12/19/2007

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Directions to “ MS. SARAH RUTH THOENSEN ” Practice Location

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