Provider Demographics
NPI:1902308802
Name:MAGNELLI, TONI MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:MARIE
Last Name:MAGNELLI
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 1:1900 WATERDAM PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-5442
Mailing Address - Country:US
Mailing Address - Phone:724-260-7531
Mailing Address - Fax:724-260-7532
Practice Address - Street 1:1900 WATERDAM PLAZA DR
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-5442
Practice Address - Country:US
Practice Address - Phone:724-260-7531
Practice Address - Fax:724-260-7532
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA007536363A00000X
PAMA064942363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104261090Medicaid
16054711OtherCAQH