Provider Demographics
NPI:1306897129
Name:ZELLER, ERIN M (PA-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:ZELLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 OSTRUM ST
Mailing Address - Street 2:SUITE 603
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1155
Mailing Address - Country:US
Mailing Address - Phone:610-954-3990
Mailing Address - Fax:610-868-2915
Practice Address - Street 1:701 OSTRUM ST
Practice Address - Street 2:SUITE 603
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1155
Practice Address - Country:US
Practice Address - Phone:610-954-3990
Practice Address - Fax:610-864-2915
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA051468363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50044647OtherCAPITAL BLUE CROSS
PA2001170OtherKEYSTONE CENTRAL
PA20045754OtherAMERIHEALTH MERCY
PAQ30219Medicare UPIN
PA50044647OtherCAPITAL BLUE CROSS