Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD449366 | PA |
N | 207PP0204X | Pediatric Emergency Physician | 273724 | MA |
NPI | 1386937241 |
---|---|
Provider Name | Sarah Catherine Cavallaro |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2011 |
Last Update Date | 16/05/2018 |