Provider Demographics
NPI:1518915107
Name:TRESSLER, DONALD L (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:L
Last Name:TRESSLER
Suffix:
Gender:M
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 1:12560 STATE ROUTE 405
Mailing Address - Street 2:
Mailing Address - City:WATSONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17777-8525
Mailing Address - Country:US
Mailing Address - Phone:570-538-2501
Mailing Address - Fax:570-538-3227
Practice Address - Street 1:7 DOCK HILL RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:PA
Practice Address - Zip Code:17842-8910
Practice Address - Country:US
Practice Address - Phone:570-837-2123
Practice Address - Fax:570-837-2185
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA002220363A00000X
PAMA051971363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q45640Medicare UPIN
PA091749Medicare PIN