Provider Demographics
NPI:1447776018
Name:ALFSON, SARAH KATHRYN (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KATHRYN
Last Name:ALFSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:SILVERSTEIN 2
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4238
Mailing Address - Country:US
Mailing Address - Phone:215-662-3807
Mailing Address - Fax:609-921-9055
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:SILVERSTEIN 2
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4238
Practice Address - Country:US
Practice Address - Phone:215-662-3807
Practice Address - Fax:609-921-9055
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1144478363A00000X
PAMA059197363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant