Healthcare Provider Details

I. General information

NPI: 1003843053
Provider Name (Legal Business Name): SARA JO RITCHEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA JO ZUCHOWSKI PA-C

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 GRAMPIAN BLVD
WILLIAMSPORT PA
17701-1907
US

IV. Provider business mailing address

1201 GRAMPIAN BLVD
WILLIAMSPORT PA
17701-1900
US

V. Phone/Fax

Practice location:
  • Phone: 570-320-7680
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA052362
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: