Provider Demographics
NPI:1851157895
Name:RYAN, SARAH XIAO (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:XIAO
Last Name:RYAN
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 1:485 FISH HATCHERY RD
Mailing Address - Street 2:
Mailing Address - City:NEW PARIS
Mailing Address - State:PA
Mailing Address - Zip Code:15554-8222
Mailing Address - Country:US
Mailing Address - Phone:814-494-6576
Mailing Address - Fax:
Practice Address - Street 1:239 COLONNADE BLVD
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2668
Practice Address - Country:US
Practice Address - Phone:582-220-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA006876207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery