Provider Demographics
NPI:1407858277
Name:BREINDEL, ANNE M (PA-C)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:BREINDEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-375-4200
Mailing Address - Fax:814-375-4232
Practice Address - Street 1:761 JOHNSONBURG RD
Practice Address - Street 2:SUITE 240
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-3483
Practice Address - Country:US
Practice Address - Phone:814-834-6565
Practice Address - Fax:814-834-7424
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA002264L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA065323Q83Medicare ID - Type Unspecified