Individual provider · Type 1 NPI

Elissa Pettinato, PA-C

Medical Physician Assistant · Philadelphia, PA

NPI number 1962936336 Active

Practice location

561 Fairthorne Ave
Philadelphia, PA 19128-2412

Call (800) 235-0200 Map

Mailing address

5443 Houghton Pl, Apt. 1
Philadelphia, PA 19128-2816

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XOA004035 (PA)
Physician Assistant 363A00000X25MP00429700 (NJ)
Medical Physician Assistant Primary 363AM0700XMA058812 (PA)

Medical Physician Assistant: Definition to come...

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About NPI 1962936336

Elissa Pettinato, PA-C's National Provider Identifier is 1962936336, issued on Apr 12, 2017. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Philadelphia, PA. The record was last updated on Apr 12, 2017.