Provider Demographics
NPI:1194144683
Name:MAZZANTI, MORINA (PA-C)
Entity type:Individual
Prefix:
First Name:MORINA
Middle Name:
Last Name:MAZZANTI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MORINA
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1211 WILMINGTON AVE
Mailing Address - Street 2:UPMC JAMESON HVI
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-2516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1211 WILMINGTON AVE
Practice Address - Street 2:UPMC JAMESON HVI
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-2516
Practice Address - Country:US
Practice Address - Phone:724-698-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056807363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical