Provider Demographics
NPI:1447600895
Name:BEMBIC, AMANDA L (PA-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:BEMBIC
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:L
Other - Last Name:EMAHIZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4815 LIBERTY AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-578-1152
Mailing Address - Fax:412-605-6669
Practice Address - Street 1:4815 LIBERTY AVE STE 250
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-578-1152
Practice Address - Fax:412-605-6669
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058229363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA13872795OtherCAQH
PA1032088750001Medicaid