Provider Demographics
NPI:1154661452
Name:DORONDO, ERICA (PA)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:DORONDO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:313 FORD ST
Mailing Address - Street 2:SUITE 2 A
Mailing Address - City:FORD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16226-1268
Mailing Address - Country:US
Mailing Address - Phone:724-763-7144
Mailing Address - Fax:724-763-7161
Practice Address - Street 1:313 FORD ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:FORD CITY
Practice Address - State:PA
Practice Address - Zip Code:16226-1268
Practice Address - Country:US
Practice Address - Phone:724-763-7144
Practice Address - Fax:724-763-7161
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA055994363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical