| Doctor Name: | MANDY COLLINS SILLICK |
| NPI Number: | 1033255427 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | MA052865 |
| Business Practice Address: | 1001 E 2nd St Coudersport, PA - 169158161 |
| Business Phone Number: | 8142605471 |
| Business Fax Number: | 8142605473 |
| Mailing Address: | 506 E Oak St, COUDERSPORT |
| State: | PA |
| Postal Code: | 169151541 |
| Phone Number: | 8142740658 |
| Fax Number: | 8142748153 |
| NPI Enumeration Date: | 01/30/2007 |
| NPI Last Update Date: | 12/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA052865 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |