Provider Demographics
NPI:1659457976
Name:GALVIN, MELISSA ANN (PA-C, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:GALVIN
Suffix:
Gender:F
Credentials:PA-C, ATC, CSCS
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:NADEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, CSCS
Mailing Address - Street 1:2550 MOSSIDE BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3533
Mailing Address - Country:US
Mailing Address - Phone:412-373-1600
Mailing Address - Fax:412-373-4197
Practice Address - Street 1:2550 MOSSIDE BLVD
Practice Address - Street 2:SUITE 405
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3540
Practice Address - Country:US
Practice Address - Phone:412-373-1600
Practice Address - Fax:412-373-4197
Is Sole Proprietor?:No
Enumeration Date:2006-10-29
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058866363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1032590880001Medicaid
PA13970508OtherCAQH
PA1032590880001Medicaid