Provider Demographics
NPI:1588921282
Name:VAN DUZER, CHRISTINA (PA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:VAN DUZER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6323 STRAW ACRES RD
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17362-9141
Mailing Address - Country:US
Mailing Address - Phone:201-317-2400
Mailing Address - Fax:
Practice Address - Street 1:651 HOLIDAY DR STE 500
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-2740
Practice Address - Country:US
Practice Address - Phone:412-307-4612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059343363A00000X
NY015466-1363AM0700X
MDC0006412363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical