Provider Demographics
NPI:1679634000
Name:PARROTTA, SAMUEL P
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:P
Last Name:PARROTTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ROYAL OAK DR
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-2553
Mailing Address - Country:US
Mailing Address - Phone:724-337-9340
Mailing Address - Fax:724-339-7369
Practice Address - Street 1:2300 FREEPORT RD
Practice Address - Street 2:SUITE 25 FELDARELLI SQUARE
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-4669
Practice Address - Country:US
Practice Address - Phone:724-339-6631
Practice Address - Fax:724-339-7369
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03042237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1417985151Medicare UPIN