Provider Demographics
NPI:1174068134
Name:KOLCHINSKY, SARAH (PA-C)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:KOLCHINSKY
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 1:23 EGREMONT RD
Mailing Address - Street 2:APT #4
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-7329
Mailing Address - Country:US
Mailing Address - Phone:248-914-8040
Mailing Address - Fax:
Practice Address - Street 1:23 EGREMONT RD
Practice Address - Street 2:APT #4
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-7329
Practice Address - Country:US
Practice Address - Phone:248-914-8040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA6016363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant