Healthcare Provider Details

I. General information

NPI: 1518915107
Provider Name (Legal Business Name): DONALD L. TRESSLER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 12/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 DOCK HILL RD
MIDDLEBURG PA
17842-8910
US

IV. Provider business mailing address

12560 STATE ROUTE 405
WATSONTOWN PA
17777-8525
US

V. Phone/Fax

Practice location:
  • Phone: 570-837-2123
  • Fax: 570-837-2185
Mailing address:
  • Phone: 570-538-2501
  • Fax: 570-538-3227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberOA002220
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA051971
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: