Provider Demographics
NPI:1366529984
Name:EMANS, SARAH JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:JEAN
Last Name:EMANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:S.
Other - Middle Name:JEAN H
Other - Last Name:EMANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:DIVISION OF ADOLESCENT MEDICINE LO638
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-7170
Mailing Address - Fax:617-730-0185
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:DIVISION OF ADOLESCENT MEDICINE LO638
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-7170
Practice Address - Fax:617-730-0185
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35510208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2037260Medicaid
M09036Medicare ID - Type Unspecified
E10398Medicare UPIN