Provider Demographics
NPI:1396026480
Name:POLONIA, CHELSA A (PA-C)
Entity Type:Individual
Prefix:
First Name:CHELSA
Middle Name:A
Last Name:POLONIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHELSA
Other - Middle Name:A
Other - Last Name:MCLAUGHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-534-1095
Mailing Address - Fax:814-534-6145
Practice Address - Street 1:320 MAIN ST
Practice Address - Street 2:2ND FL
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-1601
Practice Address - Country:US
Practice Address - Phone:814-534-1095
Practice Address - Fax:814-534-6145
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003305363AM0700X
PAMA055469363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical