Provider Demographics
NPI:1144476748
Name:DANIELS, JUDITH ANN
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:DANIELS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:A
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:1601 PENN AVE
Mailing Address - Street 2:APT. 209E
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-5003
Mailing Address - Country:US
Mailing Address - Phone:412-243-4982
Mailing Address - Fax:412-243-4982
Practice Address - Street 1:VA PITTSBURGH HEALTHCARE SYSTEM
Practice Address - Street 2:7180 HIGHLAND DRIVE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1297
Practice Address - Country:US
Practice Address - Phone:412-365-4929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001063L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical