Provider Demographics
NPI:1083273098
Name:DORAZIO, JARRETT SETH (PA-C)
Entity type:Individual
Prefix:
First Name:JARRETT
Middle Name:SETH
Last Name:DORAZIO
Suffix:
Gender:M
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 1:176 COUNTRYSIDE LN
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:PA
Mailing Address - Zip Code:15627-3618
Mailing Address - Country:US
Mailing Address - Phone:724-261-8201
Mailing Address - Fax:
Practice Address - Street 1:108 HORNER LN
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-5215
Practice Address - Country:US
Practice Address - Phone:724-537-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty