Provider Demographics
NPI:1477603850
Name:SARA C. ROCHESTER, MD, PC
Entity Type:Organization
Organization Name:SARA C. ROCHESTER, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:CASTO
Authorized Official - Last Name:ROCHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-880-1630
Mailing Address - Street 1:4810 WHITESPORT CIR SW
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-7419
Mailing Address - Country:US
Mailing Address - Phone:256-880-1630
Mailing Address - Fax:256-880-1631
Practice Address - Street 1:4810 WHITESPORT CIR SW
Practice Address - Street 2:SUITE 203
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-7419
Practice Address - Country:US
Practice Address - Phone:256-880-1630
Practice Address - Fax:256-880-1631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL191712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC60332Medicare UPIN