Healthcare Provider Details

I. General information

NPI: 1649390865
Provider Name (Legal Business Name): SARA LACASSE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 HALL DR
AMHERST MA
01002-2751
US

IV. Provider business mailing address

31 HALL DR
AMHERST MA
01002-2751
US

V. Phone/Fax

Practice location:
  • Phone: 413-256-8561
  • Fax: 866-644-0869
Mailing address:
  • Phone: 413-256-8561
  • Fax: 866-644-0869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number2481
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: