Provider Demographics
NPI:1548299217
Name:CLEARY, SARAH R (DPT)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:R
Last Name:CLEARY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:J
Other - Last Name:RAYMUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:150 S HUNTINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4817
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 S HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-4817
Practice Address - Country:US
Practice Address - Phone:857-364-4964
Practice Address - Fax:857-364-4513
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist