Provider Demographics
NPI:1699965384
Name:HETU, SARAH ALMA (OD)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ALMA
Last Name:HETU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:ALMA
Other - Last Name:HETU-RADNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:162 MIDDLESEX AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-2737
Mailing Address - Country:US
Mailing Address - Phone:978-658-3713
Mailing Address - Fax:978-658-2020
Practice Address - Street 1:174 DEAN ST
Practice Address - Street 2:SUITE B
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2782
Practice Address - Country:US
Practice Address - Phone:508-823-9307
Practice Address - Fax:508-484-2008
Is Sole Proprietor?:No
Enumeration Date:2007-07-28
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2529152W00000X
MA4725152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist