Provider Demographics
NPI:1801193370
Name:SAGAN, HEATHER ANN (PA)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANN
Last Name:SAGAN
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:305 BELMONT ST
Mailing Address - Street 2:WORCESTER STATE HOSPITAL
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1681
Mailing Address - Country:US
Mailing Address - Phone:508-368-3430
Mailing Address - Fax:508-363-1504
Practice Address - Street 1:305 BELMONT ST
Practice Address - Street 2:WORCESTER STATE HOSPITAL
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-1681
Practice Address - Country:US
Practice Address - Phone:508-368-3430
Practice Address - Fax:508-363-1504
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAPA4035363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant