ELISSA PETTINATO (NPI# 1962936336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| 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 |
| 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 |
| Street Address |
561 FAIRTHORNE AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19128-2412 |
| 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 | ||||
| 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 Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| 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 | ||||
| City | PHILADELPHIA |
| Zip Code | 19128 |
Please comment or provide details below to improve the information on ELISSA PETTINATO.
| 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.