MEDICARE: TARA DEGNAN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1023665460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA DEGNAN PA-C

Provider Business Mailing Address
First Line	:	2201 PARK MANOR BLVD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15205-4819
Country	:	US
Telephone Number	:	127-496-9204
Fax Number	:	412-749-6779

Provider Business Practice Location Address
First Line	:	2201 PARK MANOR BLVD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15205-4819
Country	:	US
Telephone Number	:	127-496-9204
Fax Number	:	412-749-6779

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2019
Last Update Date	:	08/16/2024

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Directions to “ TARA DEGNAN PA-C” Practice Location

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