MEDICARE: KENNETH PIERSON

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	MA060658	PA

General Provider Information

NPI Number	:	1346729365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH PIERSON

Provider Business Mailing Address
First Line	:	20130 ROUTE 19 STE 1000
Second Line	:	SUITE 1000
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-6218
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20130 ROUTE 19 STE 1000
Second Line	:	SUITE 1000
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-6218
Country	:	US
Telephone Number	:	724-779-7400
Fax Number	:

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

Provider Enumeration Date	:	08/09/2018
Last Update Date	:	05/24/2021

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Directions to “ KENNETH PIERSON ” Practice Location

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