Provider Demographics
NPI:1114731684
Name:GRAYBILL, EMILY MAE (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MAE
Last Name:GRAYBILL
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:MAE
Other - Last Name:COSTEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1722 LEOLYN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15210-3976
Mailing Address - Country:US
Mailing Address - Phone:814-442-2211
Mailing Address - Fax:
Practice Address - Street 1:1703 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-8815
Practice Address - Country:US
Practice Address - Phone:717-801-0765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA066408363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant