Provider Demographics
NPI:1295228641
Name:FORD, SARAH L (PA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:FORD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:607-324-5404
Mailing Address - Fax:607-324-5463
Practice Address - Street 1:111 LODER ST STE A
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-1950
Practice Address - Country:US
Practice Address - Phone:607-324-5404
Practice Address - Fax:607-324-5463
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY22203363AM0700X
NY022203363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical