Healthcare Provider Details

I. General information

NPI: 1235065871
Provider Name (Legal Business Name): BREANNA MARIE DAMIANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 PERRY HWY
WEXFORD PA
15090-8491
US

IV. Provider business mailing address

328 CENTRAL DR
CRANBERRY TWP PA
16066-4409
US

V. Phone/Fax

Practice location:
  • Phone: 724-933-1800
  • Fax:
Mailing address:
  • Phone: 412-736-4090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA067852
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: