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General NPI Number Information
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NPI Number | 1982976460
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Entity Type | Individual
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Provider Name | STEVEN PRATTA PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/31/2012
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 2601 HOLME AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19152-2007
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Country | US
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Telephone | 215-335-7705
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Fax |
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Provider Business Mailing Address
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Address Line | 41 UNIVERSITY DR STE 106
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City | NEWTOWN
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State | PA
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Zip | 18940-1873
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Country | US
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Telephone | 856-686-4317
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Fax | 856-848-8536
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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 | MA055378
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License Number State | PA
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