Provider Demographics
NPI:1447793260
Name:GRAZIANO, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:GRAZIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 CENTRE AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1301
Mailing Address - Country:US
Mailing Address - Phone:412-623-7974
Mailing Address - Fax:
Practice Address - Street 1:5115 CENTRE AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1301
Practice Address - Country:US
Practice Address - Phone:412-623-7974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058612363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant