Provider Demographics
NPI:1427181452
Name:NASH, SARA A (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:A
Last Name:NASH
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6193 WARD RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-3813
Mailing Address - Country:US
Mailing Address - Phone:716-481-1159
Mailing Address - Fax:
Practice Address - Street 1:3040 AMSDELL RD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-5835
Practice Address - Country:US
Practice Address - Phone:716-646-6700
Practice Address - Fax:716-646-8515
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP52138363A00000X
NY012380363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02985133Medicaid
NY02985133Medicaid