Provider Demographics
NPI:1154380525
Name:YOSUA, ALLISON NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:NICOLE
Last Name:YOSUA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:NICOLE
Other - Last Name:PITROFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 S. CATON AVE.
Mailing Address - Street 2:BOX 207
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229
Mailing Address - Country:US
Mailing Address - Phone:410-368-2414
Mailing Address - Fax:410-368-8644
Practice Address - Street 1:900 S. CATON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229
Practice Address - Country:US
Practice Address - Phone:410-368-2414
Practice Address - Fax:410-951-4007
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002750363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P97858Medicare UPIN
MDK519G944Medicare ID - Type Unspecified