Healthcare Provider Details

I. General information

NPI: 1164356085
Provider Name (Legal Business Name): AIDEN MICHAEL BARNETT PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4133 MEDICAL CENTER DR
BROAD TOP PA
16621-9001
US

IV. Provider business mailing address

4133 MEDICAL CENTER DR
BROAD TOP PA
16621-9001
US

V. Phone/Fax

Practice location:
  • Phone: 814-635-2916
  • Fax: 814-635-2918
Mailing address:
  • Phone: 814-635-2916
  • Fax: 814-635-2918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: