Provider Demographics
NPI:1295228641
Name:FORD, SARAH L (PA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:FORD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5877 OLD STATE RT 19
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:14813
Mailing Address - Country:US
Mailing Address - Phone:585-268-5700
Mailing Address - Fax:853-201-0695
Practice Address - Street 1:5877 OLD STATE RT 19
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NY
Practice Address - Zip Code:14813
Practice Address - Country:US
Practice Address - Phone:585-268-5700
Practice Address - Fax:585-320-1069
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY22203363AM0700X
NY022203363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical