Healthcare Provider Details

I. General information

NPI: 1932509171
Provider Name (Legal Business Name): SARA GREENWOOD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SUSAN DR
JOHNSTOWN PA
15905-2826
US

IV. Provider business mailing address

100 SUSAN DR
JOHNSTOWN PA
15905-2826
US

V. Phone/Fax

Practice location:
  • Phone: 814-241-7286
  • Fax:
Mailing address:
  • Phone: 814-255-1963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMA057124
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: