Provider Demographics
NPI:1841831229
Name:DELLA-TORRE, DEANNA LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:LYNN
Last Name:DELLA-TORRE
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 1:998 MCMULLEN RD
Mailing Address - Street 2:
Mailing Address - City:ASHVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16613-7410
Mailing Address - Country:US
Mailing Address - Phone:732-713-2611
Mailing Address - Fax:
Practice Address - Street 1:620 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4804
Practice Address - Country:US
Practice Address - Phone:814-889-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA061128363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant