Individual provider · Type 1 NPI

Sara Jane Wallace, PA

Medical Physician Assistant · New Haven, CT

NPI number 1619993334 Active

Practice location

1450 Chapel St
New Haven, CT 06511-4405

Mailing address

512 Scenic Rd
Orange, CT 06477-2127

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X001693 (CT)

Medical Physician Assistant: Definition to come...

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About NPI 1619993334

Sara Jane Wallace, PA's National Provider Identifier is 1619993334, issued on Jul 14, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in New Haven, CT. The record was last updated on Jul 8, 2007.