Provider Demographics
NPI:1285243311
Name:LAFRENIERE, SARA (PA)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:LAFRENIERE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:1781 CENTRAL ST APT 1109
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-1448
Mailing Address - Country:US
Mailing Address - Phone:401-617-9350
Mailing Address - Fax:
Practice Address - Street 1:300 MOUNT AUBURN ST STE 414
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5665
Practice Address - Country:US
Practice Address - Phone:617-864-0503
Practice Address - Fax:617-441-4033
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIPA01248363AM0700X
MAPA7800363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical