Healthcare Provider Details

I. General information

NPI: 1134842917
Provider Name (Legal Business Name): MARIE REUSS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2580 HAYMAKER RD STE 106
MONROEVILLE PA
15146-3500
US

IV. Provider business mailing address

2580 HAYMAKER RD STE 106
MONROEVILLE PA
15146-3500
US

V. Phone/Fax

Practice location:
  • Phone: 412-858-7766
  • Fax:
Mailing address:
  • Phone: 412-858-7766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA064000
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier104136485
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier16149313
Identifier TypeOTHER
Identifier State
Identifier IssuerCAQH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: