Healthcare Provider Details

I. General information

NPI: 1275519415
Provider Name (Legal Business Name): NATALIE D. AUSTIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATALIE D WHITE PA-C

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2418 E YORK ST
PHILADELPHIA PA
19125-3006
US

IV. Provider business mailing address

99 SELDOM SEEN RD
BRADFORDWOODS PA
15015-1321
US

V. Phone/Fax

Practice location:
  • Phone: 888-803-3370
  • Fax: 888-803-3331
Mailing address:
  • Phone: 412-974-7355
  • Fax: 888-803-3331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.003094
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number62864
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA002767-L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5601010527
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number028054
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number2502
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: