Provider Demographics
NPI:1497426910
Name:KILCOIN, TORI (PA-C)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:
Last Name:KILCOIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 181
Mailing Address - Street 2:
Mailing Address - City:BOYERS
Mailing Address - State:PA
Mailing Address - Zip Code:16020-0181
Mailing Address - Country:US
Mailing Address - Phone:724-602-6635
Mailing Address - Fax:
Practice Address - Street 1:129 ONEIDA VALLEY RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2252
Practice Address - Country:US
Practice Address - Phone:724-482-2717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA062888363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical