Doctor Name: | KAREN PETRISIN |
NPI Number: | 1174642979 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | |
Business Practice Address: | 1000 Higbee Dr Ste 104 Bethel Park, PA - 151024200 |
Business Phone Number: | 4128336176 |
Business Fax Number: | |
Mailing Address: | 133 Breezewood Dr, VENETIA |
State: | PA |
Postal Code: | 15367 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/29/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |