Provider Demographics
NPI:1194828244
Name:DALTON, SARA HAYES (NP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:HAYES
Last Name:DALTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PARRISH STREET
Mailing Address - Street 2:MM EWING CONTINUING CARE CENTER
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424
Mailing Address - Country:US
Mailing Address - Phone:585-396-6588
Mailing Address - Fax:585-396-6806
Practice Address - Street 1:350 PARRISH STREET
Practice Address - Street 2:MM EWING CONTINUING CARE CENTER
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424
Practice Address - Country:US
Practice Address - Phone:585-396-6588
Practice Address - Fax:585-396-6806
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
R75272Medicare UPIN