Provider Demographics
NPI:1811328925
Name:PERRONE, AMANDA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:PERRONE
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 1:1556 LAYTON RD
Mailing Address - Street 2:
Mailing Address - City:SCOTT TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18447-7802
Mailing Address - Country:US
Mailing Address - Phone:570-687-0996
Mailing Address - Fax:
Practice Address - Street 1:1960 HEART LAKE RD
Practice Address - Street 2:
Practice Address - City:SCOTT TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18433-7798
Practice Address - Country:US
Practice Address - Phone:570-687-0996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-29
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056424363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant