Healthcare Provider Details

I. General information

NPI: 1598410029
Provider Name (Legal Business Name): AUDREY MICHELE ZAVADA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2022
Last Update Date: 02/14/2022
Certification Date: 02/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 FORBES AVE
PITTSBURGH PA
15213-3410
US

IV. Provider business mailing address

4000 PARK WEST PL APT 302
PITTSBURGH PA
15205-5629
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-8762
  • Fax:
Mailing address:
  • Phone: 570-606-5323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: