Provider Demographics
NPI:1215507504
Name:SAUVAGEAU, DANIELLE (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:SAUVAGEAU
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 1:10 S POINTE LNDG STE 210
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-3481
Mailing Address - Country:US
Mailing Address - Phone:585-723-3330
Mailing Address - Fax:585-723-0555
Practice Address - Street 1:10 S POINTE LNDG STE 210
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-3481
Practice Address - Country:US
Practice Address - Phone:585-723-3330
Practice Address - Fax:585-723-0555
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267212084P0804X
NY026721363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry