Provider Demographics
NPI:1518336544
Name:ASTORINO, JORDYN M (PA-C)
Entity Type:Individual
Prefix:
First Name:JORDYN
Middle Name:M
Last Name:ASTORINO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JORDYN
Other - Middle Name:M
Other - Last Name:COLAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3822 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-3826
Mailing Address - Country:US
Mailing Address - Phone:814-835-1331
Mailing Address - Fax:814-835-1039
Practice Address - Street 1:3822 COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-3826
Practice Address - Country:US
Practice Address - Phone:814-835-1331
Practice Address - Fax:814-835-1039
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA057865363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant