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General NPI Number Information
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NPI Number | 1962115964
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Entity Type | Individual
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Provider Name | OLIVIA JANE PASSAFIUME PA-S
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Gender | Female
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Dates
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Enumeration Date | 01/04/2023
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Last Update Date | 11/15/2024
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Provider Practice Location 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 | 17822-1111
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Country | US
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Telephone | 570-271-6144
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Fax |
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Provider Business Mailing Address
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Address Line | 7076 ITASKA DR
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City | SAINT LOUIS
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State | MO
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Zip | 63123-1712
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Country | US
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Telephone |
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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 | OA006826
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License Number State | PA
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