Provider Demographics
NPI:1033750245
Name:BUYARSKI, KATELYN (PA-C)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:BUYARSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 PINEAPPLE ST
Mailing Address - Street 2:
Mailing Address - City:NUREMBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18241
Mailing Address - Country:US
Mailing Address - Phone:570-704-4235
Mailing Address - Fax:570-763-4493
Practice Address - Street 1:75 PINEAPPLE ST
Practice Address - Street 2:
Practice Address - City:NUREMBURG
Practice Address - State:PA
Practice Address - Zip Code:18241
Practice Address - Country:US
Practice Address - Phone:570-704-4235
Practice Address - Fax:570-763-4493
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA061141363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant