1205899432 NPI number — DR. DEBRA ANN SCHETTINI-PRASKO DO

Table of content: AMANDA MAGYAR MA, LAC (NPI 1861224925)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205899432 NPI number — DR. DEBRA ANN SCHETTINI-PRASKO DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHETTINI-PRASKO
Provider First Name:
DEBRA
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205899432
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
531 GRIFFITH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HASTINGS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16646-7405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-948-6289
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2128 OAKLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701-3384
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-463-1064
Provider Business Practice Location Address Fax Number:
724-723-2873
Provider Enumeration Date:
04/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  OS008534L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0015850910010 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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