Basic Information
Provider Information
NPI: 1053386086
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HALL
FirstName: SARA
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 60 EAST ST
Address2: STE 1400
City: METHUEN
State: MA
PostalCode: 018444550
CountryCode: US
TelephoneNumber: 9786894601
FaxNumber:  
Practice Location
Address1: 690 CANTON ST
Address2: SUITE 325
City: WESTWOOD
State: MA
PostalCode: 020902321
CountryCode: US
TelephoneNumber: 7814077713
FaxNumber: 7814070998
Other Information
ProviderEnumerationDate: 02/22/2006
LastUpdateDate: 03/21/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X148441MAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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