Provider Demographics
NPI:1215252515
Name:LEE, SARA L (PA-C)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:LEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16052
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-6052
Mailing Address - Country:US
Mailing Address - Phone:610-374-4404
Mailing Address - Fax:610-374-1396
Practice Address - Street 1:S SIXTH AVE AND SPRUCE ST
Practice Address - Street 2:THRMC REGIONAL CANCER CENTER
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611
Practice Address - Country:US
Practice Address - Phone:610-374-4404
Practice Address - Fax:610-374-1396
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054304363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50092796OtherCAPITAL BLUE CROSS