Provider Demographics
NPI:1639618341
Name:MATHIS, SARAH EVAN (DO)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:EVAN
Last Name:MATHIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:EVAN
Other - Last Name:FRYS MATHIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3980A SHERIDAN DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1741
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3980A SHERIDAN DR STE 200
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1741
Practice Address - Country:US
Practice Address - Phone:716-309-4772
Practice Address - Fax:716-427-6333
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302856207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY302856OtherLICENSE