Healthcare Provider Details

I. General information

NPI: 1932148400
Provider Name (Legal Business Name): LAURA A. DELLIQUADRI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8791 BARNES LAKE ROAD SUITE 101
NORTH HUNTINGDON PA
15642-3176
US

IV. Provider business mailing address

8791 BARNES LAKE ROAD SUITE 101
NORTH HUNTINGDON PA
15642-3176
US

V. Phone/Fax

Practice location:
  • Phone: 724-864-9400
  • Fax: 724-864-8044
Mailing address:
  • Phone: 724-864-9400
  • Fax: 724-864-8044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberOS000304L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: