Provider Demographics
NPI:1306240064
Name:BANASZAK, AMYE ELEANOR (PMHNP, FNP-C)
Entity type:Individual
Prefix:
First Name:AMYE
Middle Name:ELEANOR
Last Name:BANASZAK
Suffix:
Gender:F
Credentials:PMHNP, FNP-C
Other - Prefix:
Other - First Name:AMYE
Other - Middle Name:ELEANOR
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:200 OLD POND RD STE 107
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1269
Mailing Address - Country:US
Mailing Address - Phone:412-319-7866
Mailing Address - Fax:412-914-8635
Practice Address - Street 1:200 OLD POND RD STE 107
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1269
Practice Address - Country:US
Practice Address - Phone:412-319-7866
Practice Address - Fax:412-914-8635
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014303363LF0000X
PASP027648363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily