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General NPI Number Information
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NPI Number | 1245600337
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Entity Type | Individual
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Provider Name | NICOLE BRIANA VASINKO PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 793 OLD ROUTE 119 HWY N
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City | INDIANA
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State | PA
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Zip | 15701-1372
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Country | US
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Telephone | 724-465-5576
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Fax | 724-465-5532
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Provider Business Mailing Address
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Address Line | 427 SAWMILL RD
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City | GREENSBURG
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State | PA
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Zip | 15601-6468
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Country | US
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Telephone | 724-972-3804
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA057903
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License Number State | PA
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