Provider Demographics
NPI:1407294044
Name:DUCLOS, SARAH KRUZEL (PA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:KRUZEL
Last Name:DUCLOS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:KRUZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:85 HERRICK ST
Mailing Address - Street 2:EMERGENCY DEPT. BEVERLY HOSP
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915
Mailing Address - Country:US
Mailing Address - Phone:978-922-3000
Mailing Address - Fax:
Practice Address - Street 1:85 HERRICK ST.
Practice Address - Street 2:EMERGENCY DEPT. BEVERLY HOSP
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-922-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant