MEDICARE: ANISSA PERRIN

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	50.004353	OH
2	363A00000X	Physician Assistant	MA056400	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871924571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANISSA PERRIN

Provider Business Mailing Address
First Line	:	3105 WILMINGTON RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1131
Country	:	US
Telephone Number	:	724-656-8940
Fax Number	:	724-656-8942

Provider Business Practice Location Address
First Line	:	3105 WILMINGTON RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1131
Country	:	US
Telephone Number	:	724-656-8940
Fax Number	:	724-656-8942

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

Provider Enumeration Date	:	12/05/2013
Last Update Date	:	06/11/2015

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Directions to “ ANISSA PERRIN ” Practice Location

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