Individual
SARAH L PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4300 LONDONDERRY RD, HARRISBURG, PA 17109-5317
(717) 231-8772
(717) 231-8435
Mailing address
111 S FRONT ST, HARRISBURG, PA 17101-2010
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
MA058989
PA
363AM0700X
Medical Physician Assistant
OA004113
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103289766
—
PA
Enumeration date
03/08/2017
Last updated
04/15/2021
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