Provider Demographics
NPI:1902518434
Name:GRECCO, CHELSEA (PA-C)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:GRECCO
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 1:449 TUTHILL RD
Mailing Address - Street 2:
Mailing Address - City:WAYMART
Mailing Address - State:PA
Mailing Address - Zip Code:18472-3023
Mailing Address - Country:US
Mailing Address - Phone:570-357-1153
Mailing Address - Fax:
Practice Address - Street 1:449 TUTHILL RD
Practice Address - Street 2:
Practice Address - City:WAYMART
Practice Address - State:PA
Practice Address - Zip Code:18472-3023
Practice Address - Country:US
Practice Address - Phone:570-357-1153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical