MEDICARE: AMY ELIZABETH BETSCHART P.A.-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA055243	PA

General Provider Information

NPI Number	:	1144598087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY ELIZABETH BETSCHART P.A.-C

Provider Business Mailing Address
First Line	:	11676 PERRY HIGHWAY
Second Line	:	SUITE 2305
City	:	WEXFORD
State	:	PA
Zip	:	15090-7200
Country	:	US
Telephone Number	:	724-935-9133
Fax Number	:	724-935-8711

Provider Business Practice Location Address
First Line	:	11676 PERRY HIGHWAY
Second Line	:	SUITE 2305
City	:	WEXFORD
State	:	PA
Zip	:	15090-7200
Country	:	US
Telephone Number	:	724-935-9133
Fax Number	:	724-935-8711

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2011
Last Update Date	:	12/21/2011

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