Provider Demographics
NPI:1477224582
Name:MARKUSON, VIOLETTE E (PA-C)
Entity Type:Individual
Prefix:
First Name:VIOLETTE
Middle Name:E
Last Name:MARKUSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:VIOLETTE
Other - Middle Name:E
Other - Last Name:TANGUAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:335 HARDING BLVD
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3228
Mailing Address - Country:US
Mailing Address - Phone:401-808-1156
Mailing Address - Fax:
Practice Address - Street 1:1200 OLD YORK RD # TOLL5
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-4100
Practice Address - Fax:215-481-4199
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA363AM0700X, 363AS0400X
PAMA063032363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical