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NPI Code Detail

MEDICARE: ALIDA SPENCER

MEDICARE: ALIDA SPENCER
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1831042555
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALIDA SPENCER
Provider Business Mailing Address
First Line : 1012 WATER ST
Second Line :
City : MEADVILLE
State : PA
Zip : 16335-3468
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1012 WATER ST
Second Line :
City : MEADVILLE
State : PA
Zip : 16335-3468
Country : US
Telephone Number : 814-333-2001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2026
Last Update Date : 02/20/2026

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1881026730 — ZACHARY R MATTERN PT
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Directions to “ ALIDA SPENCER ” Practice Location

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