Healthcare Provider Details

I. General information

NPI: 1639542673
Provider Name (Legal Business Name): JONATHAN BARON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2015
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12311 PERRY HWY
WEXFORD PA
15090-8344
US

IV. Provider business mailing address

2 ALLEGHENY CTR STE 530
PITTSBURGH PA
15212-5404
US

V. Phone/Fax

Practice location:
  • Phone: 724-884-0885
  • Fax: 724-884-0887
Mailing address:
  • Phone: 412-330-5961
  • Fax: 412-330-5844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA057846
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9110206
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: