Provider Demographics
NPI:1194828244
Name:DALTON, SARA HAYES (NP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:HAYES
Last Name:DALTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TER HEUN DR
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2503
Mailing Address - Country:US
Mailing Address - Phone:508-457-3748
Mailing Address - Fax:508-457-3749
Practice Address - Street 1:100 TER HEUN DR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2503
Practice Address - Country:US
Practice Address - Phone:508-457-3748
Practice Address - Fax:508-457-3749
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
R75272Medicare UPIN