Provider Demographics
NPI:1639608391
Name:HAMMER, SARA (PA-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HAMMER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:1 LONGFELLOW PL APT 617
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2405
Mailing Address - Country:US
Mailing Address - Phone:832-423-5011
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT STREET, BLAKE 1500
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-3874
Practice Address - Fax:617-643-4085
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAPA6977363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant