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General NPI Number Information
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NPI Number | 1821826322
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Entity Type | Individual
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Provider Name | VICTORIA PATRICIA DIECKMANN PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 3550 TERRACE STREET 613 SCAIFE HALL
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City | PITTSBURGH
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State | PA
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Zip | 15213
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Country | US
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Telephone | 412-946-2385
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Fax |
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Provider Business Mailing Address
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Address Line | 231 HAVENHILL DR
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City | BUTLER
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State | PA
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Zip | 16001-2611
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Country | US
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Telephone | 724-355-9481
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA065753
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License Number State | PA
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