Provider Demographics
NPI:1639614548
Name:TONG, SARA ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ANN
Last Name:TONG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:ANN
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:50 ELIZABETH RD
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-4452
Mailing Address - Country:US
Mailing Address - Phone:617-967-4546
Mailing Address - Fax:
Practice Address - Street 1:300 CANAL ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4558
Practice Address - Country:US
Practice Address - Phone:978-740-2912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-01
Last Update Date:2017-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266018363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily