Provider Demographics
NPI:1477093870
Name:COOLEY, SARAH (PAC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:COOLEY
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:PULLAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44 MARYLAND AVENUE
Mailing Address - Street 2:APT. 1514
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:267-240-5745
Mailing Address - Fax:
Practice Address - Street 1:9901 MEDICAL CENTER DR.
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:240-826-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058862363AM0700X
MDC0007625363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical