Provider Demographics
NPI:1699844944
Name:KATZ, SARA (PA-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:KATZ
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 1:5 ALUMNI DR
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2128
Mailing Address - Country:US
Mailing Address - Phone:603-580-6793
Mailing Address - Fax:
Practice Address - Street 1:5 ALUMNI DR
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2128
Practice Address - Country:US
Practice Address - Phone:603-580-6793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16939363A00000X
NH0660363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30336680Medicaid
ME432948299Medicaid
NHP00721594OtherRAILROAD MEDICARE
NH0006270Medicare PIN