Provider Demographics
NPI:1992083489
Name:EMSWILER, SARAH MICHELLE (OD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MICHELLE
Last Name:EMSWILER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MICHELLE
Other - Last Name:EMSWILER TANNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:201 SALEM ST
Mailing Address - Street 2:UNIT 3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02113-1171
Mailing Address - Country:US
Mailing Address - Phone:206-355-8164
Mailing Address - Fax:
Practice Address - Street 1:201 SALEM ST
Practice Address - Street 2:UNIT 3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02113-1171
Practice Address - Country:US
Practice Address - Phone:206-355-8164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4861152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist