Provider Demographics
NPI:1528783354
Name:HEIDLER, SARAH MARIA (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIA
Last Name:HEIDLER
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 1:827 BOLIVAR DR
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-3151
Mailing Address - Country:US
Mailing Address - Phone:814-932-1221
Mailing Address - Fax:
Practice Address - Street 1:2666 W STATE ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1825
Practice Address - Country:US
Practice Address - Phone:716-373-5070
Practice Address - Fax:716-701-1517
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2024-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA063952363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant