Provider Demographics
NPI:1427500628
Name:PENZ, EMILY N (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:N
Last Name:PENZ
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 1:500 CHADWICK ST
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1851
Mailing Address - Country:US
Mailing Address - Phone:412-741-2810
Mailing Address - Fax:412-741-2807
Practice Address - Street 1:500 CHADWICK ST
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1851
Practice Address - Country:US
Practice Address - Phone:412-741-2810
Practice Address - Fax:412-741-2807
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058701363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1093733933OtherGROUP NPI