Provider Demographics
NPI:1598208068
Name:ALCAZAR, ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:ALCAZAR
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 1:493 CHERRYHILL DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1166
Mailing Address - Country:US
Mailing Address - Phone:412-266-0292
Mailing Address - Fax:
Practice Address - Street 1:2575 BOYCE PLAZA RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-3925
Practice Address - Country:US
Practice Address - Phone:412-203-4057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055375363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical