TIFFANY M ICKIEWICZ (NPI# 1902101140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902101140 |
| Entity Type | Individual |
| Full Name | TIFFANY M ICKIEWICZ |
| Credential | PA-C |
| Practice Address |
991 Route 19 N Ste B Waterford PA 16441-9739 |
| Practice Telephone | 8148778790 |
| Practice Fax Number | 8147964238 |
| Mailing Telephone | 8148778790 |
| Mailing Fax Number | 8147964238 |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2019-11-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | OA002427 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | MA054038 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
991 ROUTE 19 N STE B |
| City | WATERFORD |
| State | PA |
| Zip Code | 16441-9739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497750129 | Nathan M Moore | Family Medicine | 991 Route 19 N Ste B, Waterford, PA 16441-9739 | 2005-06-17 |
| 1750922100 | Caitlin Anne Ebert | Physician Assistant | 991 Route 19 N Ste B, Waterford, PA 16441-9739 | 2019-10-07 |
| 1639623978 | Brian Michael Wojtkielewicz | Family Medicine | 991 Route 19 N Ste B, Waterford, PA 16441-9739 | 2016-08-03 |
| 1457762122 | Erin E Shaffer | Family Medicine | 991 Route 19 N Ste B, Waterford, PA 16441-9739 | 2014-05-15 |
| 1013974039 | Craig Douglas Caldwell | Family Medicine | 991 Route 19 N Ste B, Waterford, PA 16441-9739 | 2006-04-26 |
| 1912986605 | Carl E Eby | Family Medicine | 991 Route 19 N Ste B, Waterford, PA 16441-9739 | 2006-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588055057 | Goods Counseling Services LLC | Counselor | 412 High St., Waterford, PA 16441 | 2015-02-05 |
| 1336468941 | Dinesh Nandlal Patel | Dentist | 9271 Peach Street, Waterford, PA 16441 | 2010-05-21 |
| 1366654485 | Hamot Health Foundation | Non-Pharmacy Dispensing Site | 991 Route 19, B, Waterford, PA 16441 | 2007-05-03 |
| 1275626798 | Keiser Family Eyecare, P.C. | Durable Medical Equipment & Medical Supplies | 503 High Street, Waterford, PA 16441 | 2006-10-02 |
| 1316961733 | David Scott Teufel | Dentist | 901 High Street, Waterford, PA 16441 | 2006-07-27 |
| 1508821687 | Douglas P Lichtinger Dc Inc | Chiropractor | 212 High Street, Waterford, PA 16441 | 2006-04-20 |
| 1831178953 | Gregory Lee Waite | Physical Therapist | 991 Route 19n, Suite E, Waterford, PA 16441 | 2006-01-17 |
| 1023092848 | Helpmates Inc | Home Health | 115 High St, Waterford, PA 16441 | 2005-12-05 |
| 1528579695 | Summit Family Dentistry, Pllc | Clinic/Center | 9271 Peach Street, Waterford, PA 16441 | 2017-10-17 |
| 1659762185 | Jennifer Good | Counselor | 412 High St., Waterford, PA 16441 | 2015-02-05 |
| Find all providers in zip 16441 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770117335 | Madeleine Crawford | Physician Assistant | 528 Fairview Cir, Waterford, WI 53185-2874 | 2020-02-23 |
| 1316448186 | Jewels George | Physician Assistant | 3803 Elizabeth Lake Rd, Waterford, MI 48328-3017 | 2018-02-26 |
| 1649553959 | Jamie Rose Rosenthal | Physician Assistant | 6620 Highland Rd Ste 101, Waterford, MI 48327-1682 | 2011-09-22 |
| 1104800903 | Michael H Buchal | Physician Assistant | 2710 Sylvan Shores Dr, Waterford, MI 48328 | 2005-12-05 |
| 1750922100 | Caitlin Anne Ebert | Physician Assistant | 991 Route 19 N Ste B, Waterford, PA 16441-9739 | 2019-10-07 |
| 1083270094 | Anitta Varghese | Physician Assistant | 1901 N Telegraph Rd, Waterford, MI 48328-1878 | 2019-05-15 |
| 1164992285 | Lucy Khalil Hanna | Physician Assistant | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 | 2018-12-01 |
| 1205204385 | Kelly Backers | Physician Assistant | 1012 W Huron St, Waterford, MI 48328-3730 | 2015-09-08 |
| 1427431840 | Julie Zito | Physician Assistant | 196 Parkway S, Suite303, Waterford, CT 06385-1234 | 2015-07-02 |
| 1396177556 | Stephanie Elizabeth Rae Fulton | Physician Assistant | 4800 Highland Rd, Waterford, MI 48328-1176 | 2013-07-30 |
| Find all providers in WATERFORD | ||||
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| 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.