Provider Demographics
NPI:1346390002
Name:SORICHETTI, TONI MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:MARIE
Last Name:SORICHETTI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:MARIE
Other - Last Name:SCANLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2589 BOYCE PLAZA RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-4907
Mailing Address - Country:US
Mailing Address - Phone:412-232-8104
Mailing Address - Fax:412-281-1898
Practice Address - Street 1:2589 BOYCE PLAZA RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-4907
Practice Address - Country:US
Practice Address - Phone:412-232-8104
Practice Address - Fax:412-281-1898
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002824L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA002824LOtherPA-C LICENSE
PA023092J8WMedicare ID - Type Unspecified