ELISSA PETTINATO


Address: 561 Fairthorne Ave, Philadelphia, PA 19128-2412
Phone: 8002350200

ELISSA PETTINATO (NPI# 1962936336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962936336
Entity Type Individual
Full Name ELISSA PETTINATO
Credential PA-C
Practice Address 561 Fairthorne Ave
Philadelphia
PA 19128-2412
Mailing Address 5443 Houghton Pl
Apt. 1
Philadelphia
PA 19128-2816
Practice Telephone 8002350200
Mailing Telephone 8142278403
Enumeration Date 2017-04-12
Last Update Date 2017-04-12
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363A00000X Physician Assistant 25MP00429700 NJ Physician Assistants & Advanced Practice Nursing Providers
N 363A00000X Physician Assistant OA004035 PA Physician Assistants & Advanced Practice Nursing Providers
Y 363AM0700X Physician Assistant
Specialization: Medical
MA058812 PA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 561 FAIRTHORNE AVE
City PHILADELPHIA
State PA
Zip Code 19128-2412

Providers in the same location

NPI Name Taxonomy Address Enumeration
1992775977 Kenneth Norman Vermette Family Medicine 561 Fairthorne Ave, Philadelphia, PA 19128-2412 2006-01-24
1457991416 Christiana Ayeni Nurse Practitioner 561 Fairthorne Ave, Philadelphia, PA 19128-2412 2020-01-08
1326689753 Colleen Chiu Nurse Practitioner 561 Fairthorne Ave, Philadelphia, PA 19128-2412 2019-10-07
1891268884 Sarah Kish Family Medicine 561 Fairthorne Ave, Philadelphia, PA 19128-2412 2019-01-02
1407240344 Ahmed Fayed Psychiatry & Neurology 561 Fairthorne Ave, Philadelphia, PA 19128-2412 2015-03-27
1487099826 Mohammed Daher Psychiatry & Neurology 561 Fairthorne Ave, Philadelphia, PA 19128-2412 2013-04-29
1013258177 Lawrence H Han Psychiatry & Neurology 561 Fairthorne Ave, Philadelphia, PA 19128-2412 2013-03-13
1114231966 Christine Sloan Nurse Practitioner 561 Fairthorne Ave, Philadelphia, PA 19128-2412 2010-08-04
1295046241 Matthias Sommer Psychiatry & Neurology 561 Fairthorne Ave, Philadelphia, PA 19128-2412 2010-06-24
1083875124 Joseph Yi Psychiatry & Neurology 561 Fairthorne Ave, Philadelphia, PA 19128-2412 2008-06-20
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851877179 Andrew Mermelstein Podiatrist 5800 Roxborough Avenue, Philadelphia, PA 19128 2018-07-19
1811499361 Ursula Wacyk Social Worker 6122 Ridge Avenue, Philadelphia, PW 19128 2018-03-01
1417478454 Chelsea Lynn Roberts Physician Assistant 707 Autumn River Run, Philadelphia, PA 19128 2017-06-29
1174060503 Melody Ann Piranian Nurse Practitioner Andorra Pediatrics, 8945 Ridge Ave St 5, Phila, PA 19128 2017-01-24
1154874410 Meghan Smith Pharmacist 5927-59 Ridge Ave, Philadelphia, PA 19128 2016-08-03
1356797880 Jenna Angelo Registered Nurse 457 Spring Lane, Philadelphia, PA 19128 2016-05-13
1689049843 Newcourtland Senior Centers Clinic/Center 4200b Mitchell Street, Suie 1000, Philadelphia, PA 19128 2015-12-14
1235519331 Merin Wexler Social Worker 6060 Ridge Avenue, Suite 210, Philadelphia, PA 19128 2015-06-03
1457754335 Sarah De Simone Specialist/Technologist 318 Fountain Street, Philadelphia, PA 19128 2014-10-06
1609280049 Sylvia Russianoff Counselor 128 Rochelle Avenue, Philadelphia, PA 19128 2014-06-13
Find all providers in zip 19128

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1467051763 Molly Catherine Peters Physician Assistant 4338 Boone St, Philadelphia, PA 19128-4901 2020-10-19
1356951024 Murielle M Boursiquot Physician Assistant 7901 Henry Ave Apt G302, Philadelphia, PA 19128-3072 2020-08-06
1134757156 Julie Hutchison Physician Assistant 2922 N 5th St, Philadelphia, PA 19133-2801 2020-03-27
1174155857 Rebecca Volpe Physician Assistant 738 Longshore Ave, Philadelphia, PA 19111-4325 2020-02-10
1306308879 Ria Raju Physician Assistant 7909 Lawndale Ave, Philadelphia, PA 19111-2652 2019-04-03
1386101400 Ashley Thomas Physician Assistant 9331 Old Bustleton Ave Ste 100a, Philadelphia, PA 19115 2019-02-25
1487119186 Shelby Elizabeth Ginsburg Physician Assistant 1200 W Tabor Rd Fl Bl4, Philadelphia, PA 19141-3019 2019-02-06
1346720059 Noelle Elizabeth Mullanaphy Physician Assistant 4031 Sheffield St, Philadelphia, PA 19136-3101 2018-08-21
1750860490 Anastasiya Khlypnych Physician Assistant 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 2018-08-13
1912409533 Lauren Joy Barton Physician Assistant 5401 N Broad St Ste 363, Philadelphia, PA 19141 2018-02-28
Find all providers in PHILADELPHIA

Competitor

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City PHILADELPHIA
Zip Code 19128

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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