Provider Demographics
NPI:1225039217
Name:SCAFFARDI, RACHEL N (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:N
Last Name:SCAFFARDI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:N
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2011 LAVEEN ST
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-3127
Mailing Address - Country:US
Mailing Address - Phone:724-879-8500
Mailing Address - Fax:
Practice Address - Street 1:530 SOUTH ST STE 200
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2775
Practice Address - Country:US
Practice Address - Phone:724-689-1070
Practice Address - Fax:724-689-1063
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA002116363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
059969Medicare PIN
PAP64303Medicare UPIN