Provider Demographics
NPI:1154787893
Name:BRAHOSKY, LINDSAY MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:BRAHOSKY
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 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:2581 CLYDE AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7508
Practice Address - Country:US
Practice Address - Phone:814-626-2500
Practice Address - Fax:814-940-6517
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058070363AM0700X
PAOA003888208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice