Healthcare Provider Details

I. General information

NPI: 1841831229
Provider Name (Legal Business Name): DEANNA LYNN DELLA-TORRE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 01/25/2024
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 HOWARD AVE
ALTOONA PA
16601-4804
US

IV. Provider business mailing address

998 MCMULLEN RD
ASHVILLE PA
16613-7410
US

V. Phone/Fax

Practice location:
  • Phone: 814-889-2011
  • Fax:
Mailing address:
  • Phone: 732-713-2611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA061128
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: