Provider Demographics
NPI:1578030391
Name:POKITA, TERESA ELIZABETH ROSE (PAS)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ELIZABETH ROSE
Last Name:POKITA
Suffix:
Gender:F
Credentials:PAS
Other - Prefix:
Other - First Name:TESS
Other - Middle Name:E
Other - Last Name:POKITA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PAS
Mailing Address - Street 1:250 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2706
Mailing Address - Country:US
Mailing Address - Phone:724-774-4070
Mailing Address - Fax:
Practice Address - Street 1:250 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2706
Practice Address - Country:US
Practice Address - Phone:724-774-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical