MEDICARE: MRS. ELIZABETH ANNE BACHIOCHI PA-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	0010-01993	NC

General Provider Information

NPI Number	:	1710078860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH ANNE BACHIOCHI PA-C

Provider Business Mailing Address
First Line	:	1194 OLD STILL WAY
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587
Country	:	US
Telephone Number	:	919-539-3621
Fax Number	:

Provider Business Practice Location Address
First Line	:	451 RUIN CREEK RD
Second Line	:	SUITE 101
City	:	HENDERSON
State	:	NC
Zip	:	27536-2878
Country	:	US
Telephone Number	:	252-492-9565
Fax Number	:

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	09/11/2009

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