Healthcare Provider Details

I. General information

NPI: 1487934436
Provider Name (Legal Business Name): SARAH L ALTO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH L GOODRICH

II. Dates (important events)

Enumeration Date: 08/23/2011
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WELLNESS WAY
TOPSHAM ME
04086-1768
US

IV. Provider business mailing address

PO BOX 360489
PITTSBURGH PA
15251-6489
US

V. Phone/Fax

Practice location:
  • Phone: 207-406-7600
  • Fax: 207-618-5683
Mailing address:
  • Phone: 207-661-5490
  • Fax: 207-661-8523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP111066
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: