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General NPI Number Information
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NPI Number | 1255527495
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Entity Type | Individual
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Provider Name | SUZZANE ROENA PISTOLE PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 1509 STONECREEK DR S
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City | PICKERINGTON
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State | OH
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Zip | 43147-9836
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Country | US
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Telephone | 740-653-2500
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Fax | 740-653-2552
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Provider Business Mailing Address
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Address Line | 7951 SHOAL CREEK BLVD STE 300
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City | AUSTIN
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State | TX
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Zip | 78757-7582
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Country | US
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Telephone | 512-584-8404
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Fax | 737-377-0442
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.002818
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License Number State | OH
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