Provider Demographics
NPI:1942351507
Name:SARA GRANOFF-SCHOR, DPM, INC.
Entity type:Organization
Organization Name:SARA GRANOFF-SCHOR, DPM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:ROBIN
Authorized Official - Last Name:GRANOFF-SCHOR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:401-944-4770
Mailing Address - Street 1:960 RESERVOIR AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-4446
Mailing Address - Country:US
Mailing Address - Phone:401-944-4770
Mailing Address - Fax:401-944-4771
Practice Address - Street 1:960 RESERVOIR AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-4446
Practice Address - Country:US
Practice Address - Phone:401-944-4770
Practice Address - Fax:401-944-4771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDPM00226213E00000X
RIDPM00257213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI000257OtherTUFTS
RI004590OtherBLUE CHIP
RI2262449OtherAETNA
RI27-00172OtherUNITED HEALTHCARE
RI480026885OtherRAILROAD MEDICARE
RISG07157Medicaid
RI1942351507OtherNPI
RI33398OtherPILGRIM
RI0137578005OtherCIGNA
RI70010000ZBC069OtherBLUE CROSS MASSACHUSETTS
RI7064-4OtherBLUE CROSS
RIDPM00257OtherRI LICENSE
RIBG1965992OtherDEA
RI000257OtherTUFTS
RI2262449OtherAETNA
RI70010000ZBC069OtherBLUE CROSS MASSACHUSETTS