Provider Demographics
NPI:1528154267
Name:STRATFORD, SANDRA DIANE (MD, MSC)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:DIANE
Last Name:STRATFORD
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Gender:F
Credentials:MD, MSC
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Mailing Address - Street 1:75 CAMBRIDGE PARKWAY
Mailing Address - Street 2:E1106
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02142
Mailing Address - Country:US
Mailing Address - Phone:781-290-2213
Mailing Address - Fax:781-290-2215
Practice Address - Street 1:1601 TRAPELO RD
Practice Address - Street 2:SUITE 176
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451
Practice Address - Country:US
Practice Address - Phone:781-290-2210
Practice Address - Fax:781-290-2215
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA2053162083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE71692Medicare UPIN