Provider Demographics
NPI:1831156074
Name:NIGLIO, PATRICIA ANN (PAC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:NIGLIO
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:CANINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 NORTH ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:100 NORTH ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-2130
Practice Address - Country:US
Practice Address - Phone:570-271-6541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA00768L363A00000X
PAMA000768L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50072827OtherKEYSTONE CAPITAL BC
PA50072827OtherKEYSTONE CAPITAL BC