Provider Demographics
NPI:1689366510
Name:VIMINI, SARAH (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:VIMINI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 AUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-1801
Mailing Address - Country:US
Mailing Address - Phone:203-981-0116
Mailing Address - Fax:
Practice Address - Street 1:3801 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-3815
Practice Address - Country:US
Practice Address - Phone:203-709-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant