Provider Demographics
NPI:1255683876
Name:FERRIE, SARAH A (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:FERRIE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:CORDANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2247 E MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705-2604
Mailing Address - Country:US
Mailing Address - Phone:203-757-3486
Mailing Address - Fax:203-757-3723
Practice Address - Street 1:2247 E MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-2604
Practice Address - Country:US
Practice Address - Phone:203-757-3486
Practice Address - Fax:203-757-3723
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002812363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004245272Medicaid