Basic Information
Provider Information
NPI: 1386971745
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALLISON
FirstName: SARAH
MiddleName: M
NamePrefix: MRS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: STEIN
OtherFirstName: SARAH
OtherMiddleName: M.
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential: PA-C
OtherLastNameType: 5
Mailing Information
Address1: 500 UNIVERSITY DR
Address2:  
City: HERSHEY
State: PA
PostalCode: 170332360
CountryCode: US
TelephoneNumber: 8002431455
FaxNumber: 7175317269
Practice Location
Address1: 500 UNIVERSITY DR
Address2:  
City: HERSHEY
State: PA
PostalCode: 170332360
CountryCode: US
TelephoneNumber: 7175318161
FaxNumber: 7175317726
Other Information
ProviderEnumerationDate: 11/05/2009
LastUpdateDate: 12/06/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMA054103PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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