Provider Demographics
NPI:1255628830
Name:AOUN, SARA ANN (PA-C)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:ANN
Last Name:AOUN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ANN
Other - Last Name:COLOPRISCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:25 HACKETT BLVD
Mailing Address - Street 2:MC164
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3462
Mailing Address - Country:US
Mailing Address - Phone:518-262-5511
Mailing Address - Fax:
Practice Address - Street 1:25 HACKETT BLVD
Practice Address - Street 2:MC164
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3462
Practice Address - Country:US
Practice Address - Phone:518-262-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2016-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014801363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant