Provider Demographics
NPI:1679829063
Name:PAPP, AMANDA M (PA-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:PAPP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:M
Other - Last Name:MCGAUGHEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4815 LIBERTY AVE STE 425
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-359-4352
Mailing Address - Fax:412-359-8285
Practice Address - Street 1:4815 LIBERTY AVE STE 425
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-359-4352
Practice Address - Fax:412-359-8285
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055613363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103204197Medicaid
12606510OtherCAQH