Provider Demographics
NPI:1053500348
Name:SCHIAVONE, GEANNINE ELISA (PA-C)
Entity Type:Individual
Prefix:
First Name:GEANNINE
Middle Name:ELISA
Last Name:SCHIAVONE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:GEANNINE
Other - Middle Name:ELISA
Other - Last Name:SUBBIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 OSTRUM ST
Mailing Address - Street 2:SUITE 603
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1155
Mailing Address - Country:US
Mailing Address - Phone:484-526-3990
Mailing Address - Fax:610-868-2915
Practice Address - Street 1:701 OSTRUM ST
Practice Address - Street 2:SUITE 603
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1155
Practice Address - Country:US
Practice Address - Phone:484-526-3990
Practice Address - Fax:610-868-2915
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051497363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical