MEDICARE: MR. DONALD L. TRESSLER 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	OA002220	PA
2	363AM0700X	Medical Physician Assistant	MA051971	PA

General Provider Information

NPI Number	:	1518915107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD L. TRESSLER PA-C

Provider Business Mailing Address
First Line	:	12560 STATE ROUTE 405
Second Line	:
City	:	WATSONTOWN
State	:	PA
Zip	:	17777-8525
Country	:	US
Telephone Number	:	570-538-2501
Fax Number	:	570-538-3227

Provider Business Practice Location Address
First Line	:	7 DOCK HILL RD
Second Line	:
City	:	MIDDLEBURG
State	:	PA
Zip	:	17842-8910
Country	:	US
Telephone Number	:	570-837-2123
Fax Number	:	570-837-2185

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	12/30/2008

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