Provider Demographics
NPI:1346258779
Name:SCAVO, BONITA (PA)
Entity Type:Individual
Prefix:MS
First Name:BONITA
Middle Name:
Last Name:SCAVO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ALLEGHENY CTR
Mailing Address - Street 2:SUITE 530
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5402
Mailing Address - Country:US
Mailing Address - Phone:412-231-0200
Mailing Address - Fax:412-231-0613
Practice Address - Street 1:2 ALLEGHENY CTR
Practice Address - Street 2:SUITE 530
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5402
Practice Address - Country:US
Practice Address - Phone:412-231-0200
Practice Address - Fax:412-231-0613
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000681L363A00000X, 363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Not Answered363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7015121OtherHIGHMARK
PAR05981Medicare UPIN
PA7015121OtherHIGHMARK