Healthcare Provider Details

I. General information

NPI: 1932238672
Provider Name (Legal Business Name): SARAH E LATHROP ATC, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 03/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HOPE DR MAIL CODE E140
HERSHEY PA
17033-2036
US

IV. Provider business mailing address

PO BOX 858
HERSHEY PA
17033-0858
US

V. Phone/Fax

Practice location:
  • Phone: 800-243-1455
  • Fax: 717-531-7269
Mailing address:
  • Phone: 800-243-1455
  • Fax: 717-531-7269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberRT003239
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA055277
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierMA055277
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPAC LICENSE
# 2
IdentifierRT003239
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerLICENSE NUMBER

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: