Provider Demographics
NPI:1487833117
Name:COOK, SARAH MICHELLE (PA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MICHELLE
Last Name:COOK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:MICHELLE
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:138 EAST MAIN ST
Mailing Address - City:WESTFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14787
Mailing Address - Country:US
Mailing Address - Phone:716-326-4678
Mailing Address - Fax:716-326-4914
Practice Address - Street 1:138 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NY
Practice Address - Zip Code:14787
Practice Address - Country:US
Practice Address - Phone:716-326-4678
Practice Address - Fax:716-326-4914
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant