Healthcare Provider Details

I. General information

NPI: 1811328925
Provider Name (Legal Business Name): AMANDA PERRONE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2013
Last Update Date: 08/17/2024
Certification Date: 08/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 HEART LAKE RD
SCOTT TOWNSHIP PA
18433-7798
US

IV. Provider business mailing address

1556 LAYTON RD
SCOTT TOWNSHIP PA
18447-7802
US

V. Phone/Fax

Practice location:
  • Phone: 570-687-0996
  • Fax:
Mailing address:
  • Phone: 570-687-0996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA056424
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: