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General NPI Number Information
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NPI Number | 1669216313
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Entity Type | Individual
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Provider Name | HEBA GAMAL ELRAWASHDY PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/19/2024
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 950 E MOUNTAIN DR
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City | WILKES BARRE
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State | PA
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Zip | 18711-0028
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Country | US
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Telephone | 570-808-6000
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Fax | 570-808-6061
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Provider Business Mailing Address
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Address Line | 100 N ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-4903
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Country | US
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Telephone | 570-808-6000
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Fax | 570-808-6061
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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 | MA065682
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License Number State | PA
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