Provider Demographics
NPI:1962893867
Name:FRANCESCHELLI, RYAN ANDREW (PA-C)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:ANDREW
Last Name:FRANCESCHELLI
Suffix:
Gender:M
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 1:800 PLAZA DRIVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-4019
Mailing Address - Country:US
Mailing Address - Phone:724-379-5816
Mailing Address - Fax:724-379-5874
Practice Address - Street 1:800 PLAZA DR
Practice Address - Street 2:SUITE 400
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012
Practice Address - Country:US
Practice Address - Phone:724-379-5802
Practice Address - Fax:724-379-5813
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA057436363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103256818Medicaid