Provider Demographics
NPI:1285604611
Name:SACCHETTI, DINO DOMINICK (PA-C)
Entity type:Individual
Prefix:MR
First Name:DINO
Middle Name:DOMINICK
Last Name:SACCHETTI
Suffix:
Gender:M
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 1:205 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:DICKSON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:18519-1179
Mailing Address - Country:US
Mailing Address - Phone:570-383-1932
Mailing Address - Fax:
Practice Address - Street 1:205 HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:DICKSON CITY
Practice Address - State:PA
Practice Address - Zip Code:18519-1179
Practice Address - Country:US
Practice Address - Phone:570-383-1932
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000989L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical