Provider Demographics
NPI:1427306174
Name:SARASOHN, RACHEL (RN, PNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SARASOHN
Suffix:
Gender:F
Credentials:RN, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WASHINGTON STREET
Mailing Address - Street 2:SUITE 466
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462
Mailing Address - Country:US
Mailing Address - Phone:617-969-8989
Mailing Address - Fax:617-928-0178
Practice Address - Street 1:2000 WASHINGTON STREET
Practice Address - Street 2:SUITE 466
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462
Practice Address - Country:US
Practice Address - Phone:617-969-8989
Practice Address - Fax:617-928-0178
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2266861363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics