Provider Demographics
NPI:1497137582
Name:GUARASCIO, SARAH JEAN (OD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:GUARASCIO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2757 PAWTUCKET AVENUE
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914
Mailing Address - Country:US
Mailing Address - Phone:401-434-5532
Mailing Address - Fax:401-435-5405
Practice Address - Street 1:2757 PAWTUCKET AVENUE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914
Practice Address - Country:US
Practice Address - Phone:401-434-5532
Practice Address - Fax:401-435-5405
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00647152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1497137582Medicaid