Provider Demographics
NPI:1669104998
Name:HITE, SALLY ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:ELIZABETH
Last Name:HITE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:ELIZABETH
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:429 W SEDGWICK ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-3024
Mailing Address - Country:US
Mailing Address - Phone:651-895-6510
Mailing Address - Fax:
Practice Address - Street 1:2800 KELLY RD
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-3630
Practice Address - Country:US
Practice Address - Phone:267-656-7834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant