Provider Demographics
NPI:1730516832
Name:PIZZIMENTI, ASHLEY R (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:R
Last Name:PIZZIMENTI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:R
Other - Last Name:STEPHENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:317 S. CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:QUARRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17566-1344
Mailing Address - Country:US
Mailing Address - Phone:717-786-7383
Mailing Address - Fax:717-786-8635
Practice Address - Street 1:317 S. CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:QUARRYVILLE
Practice Address - State:PA
Practice Address - Zip Code:17566-1344
Practice Address - Country:US
Practice Address - Phone:717-786-7383
Practice Address - Fax:717-786-8635
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056494363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant