Provider Demographics
NPI:1679752083
Name:NARCISO-OWEN, SANDY PAIS (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:PAIS
Last Name:NARCISO-OWEN
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 1:36 CODFISH HILL RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-3305
Mailing Address - Country:US
Mailing Address - Phone:203-744-3575
Mailing Address - Fax:
Practice Address - Street 1:SACRED HEART UNIVERSITY, PHYSICIAN ASSISTANT STUDIES
Practice Address - Street 2:5151 PARK AVENUE
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825
Practice Address - Country:US
Practice Address - Phone:039-899-2342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001990363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant