Healthcare Provider Details

I. General information

NPI: 1164494266
Provider Name (Legal Business Name): RAYMOND P PARONISH CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 VILLAGE DR
GREENSBURG PA
15601-3783
US

IV. Provider business mailing address

520 JEFFERSON AVE SUITE 400
JEANNETTE PA
15644-2538
US

V. Phone/Fax

Practice location:
  • Phone: 724-838-1900
  • Fax: 724-838-5620
Mailing address:
  • Phone: 724-527-8060
  • Fax: 724-522-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberTP005171M
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: