Provider Demographics
NPI:1265490742
Name:ZELLA-PRATER, ALLYSON CHRISTINE (PAC)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:CHRISTINE
Last Name:ZELLA-PRATER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 RODI RD STE 103
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4566
Mailing Address - Country:US
Mailing Address - Phone:412-466-3111
Mailing Address - Fax:412-469-5579
Practice Address - Street 1:665 RODI RD STE 103
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-4566
Practice Address - Country:US
Practice Address - Phone:724-547-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052396363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA098903ELMMedicare ID - Type Unspecified
Q65177Medicare UPIN