Provider Demographics
NPI:1225588460
Name:CUSHMA, KATHARINE DARIA (PA-C)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:DARIA
Last Name:CUSHMA
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 1:1145 BOWER HILL RD STE 105
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1346
Mailing Address - Country:US
Mailing Address - Phone:412-866-7246
Mailing Address - Fax:412-866-7240
Practice Address - Street 1:1145 BOWER HILL RD STE 105
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1346
Practice Address - Country:US
Practice Address - Phone:412-866-7246
Practice Address - Fax:412-866-7240
Is Sole Proprietor?:No
Enumeration Date:2016-10-12
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058593363A00000X
PAOA003928363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant