Provider Demographics
NPI:1013337807
Name:FRITSCH, SARA (PA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:FRITSCH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1718
Mailing Address - Country:US
Mailing Address - Phone:716-632-7465
Mailing Address - Fax:716-632-7464
Practice Address - Street 1:3915 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-632-7465
Practice Address - Fax:716-632-7464
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017325363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant