Provider Demographics
NPI:1710500848
Name:GHOHESTANI-BOJD, SARA (PA-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:GHOHESTANI-BOJD
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 1:70 MAIN ST
Mailing Address - Street 2:VALLEY MEDICAL GROUP, PC-NORTHAMPTON HEALTH CENTER
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1466
Mailing Address - Country:US
Mailing Address - Phone:413-586-8400
Mailing Address - Fax:866-644-0872
Practice Address - Street 1:70 MAIN ST
Practice Address - Street 2:VALLEY MEDICAL GROUP, PC-NORTHAMPTON HEALTH CENTER
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1466
Practice Address - Country:US
Practice Address - Phone:413-586-8400
Practice Address - Fax:866-644-0872
Is Sole Proprietor?:No
Enumeration Date:2020-05-23
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA58136363A00000X
MAPA8793363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant