Provider Demographics
NPI:1538597505
Name:ATHY, CARA (PA-C)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:ATHY
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 1:5783 WOOSTER PIKE
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8816
Mailing Address - Country:US
Mailing Address - Phone:307-250-5693
Mailing Address - Fax:330-662-0258
Practice Address - Street 1:5783 WOOSTER PIKE
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8816
Practice Address - Country:US
Practice Address - Phone:330-725-0569
Practice Address - Fax:330-662-0258
Is Sole Proprietor?:No
Enumeration Date:2013-10-29
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003884363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant