Provider Demographics
NPI:1285296897
Name:HAEN, SARAH ELIZABETH (PPCNP-BC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:HAEN
Suffix:
Gender:F
Credentials:PPCNP-BC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:HAEN
Other - Last Name:LONCAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PPCNP-BC
Mailing Address - Street 1:13 E PARK RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1107
Mailing Address - Country:US
Mailing Address - Phone:585-733-7111
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-1919
Practice Address - Country:US
Practice Address - Phone:585-275-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF382874-1363LP0200X
NY382874363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical