Provider Demographics
NPI:1508016510
Name:PICA, RICHELE ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:RICHELE
Middle Name:ANN
Last Name:PICA
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 1:323 WOLF DR
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9517
Mailing Address - Country:US
Mailing Address - Phone:570-498-6713
Mailing Address - Fax:
Practice Address - Street 1:240 CETRONIA ROARD
Practice Address - Street 2:SUITE 200N
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9263
Practice Address - Country:US
Practice Address - Phone:484-426-2600
Practice Address - Fax:833-816-7512
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant