Provider Demographics
NPI:1104239417
Name:TOVEN, JUSTINE MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:MARIE
Last Name:TOVEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JUSTINE
Other - Middle Name:MARIE
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825
Practice Address - Country:US
Practice Address - Phone:814-849-0990
Practice Address - Fax:814-849-0992
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
PAOA004260363AM0700X
PAMA056874363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical