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General NPI Number Information
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NPI Number | 1952398232
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Entity Type | Individual
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Provider Name | THERESA ANN GRIFFIN MARTIN PAC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 07/26/2025
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Provider Practice Location Address
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Address Line | 110 HIDDEN VALLEY RD
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City | CANONSBURG
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State | PA
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Zip | 15317-2685
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Country | US
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Telephone | 724-374-3468
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Fax | 724-258-8914
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Provider Business Mailing Address
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Address Line | 100 KERRY CT APT 1212
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City | MC MURRAY
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State | PA
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Zip | 15317-3081
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Country | US
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Telephone | 330-503-7691
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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 | 50.000540RX
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License Number State | OH
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