1255666947 NPI number — MRS. SARAH U DUGGAN

Table of content: MRS. SARAH U DUGGAN (NPI 1255666947)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255666947 NPI number — MRS. SARAH U DUGGAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUGGAN
Provider First Name:
SARAH
Provider Middle Name:
U
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HEWAT
Provider Other First Name:
SARAH
Provider Other Middle Name:
U
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1255666947
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
995 WORTHINGTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01109-4027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
844-642-9355
Provider Business Mailing Address Fax Number:
413-732-0309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 HIGH ST STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WALTHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02453-0574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-242-2200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1004745 . This is a "NHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1303287 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: M18684 . This is a "BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: NP01332 . This is a "BMC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1306421 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: M18633 . This is a "BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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