Provider Demographics
NPI:1689078776
Name:TOMES, LINDSAY PETRI (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:PETRI
Last Name:TOMES
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 1:5242 LOTUS WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-2442
Mailing Address - Country:US
Mailing Address - Phone:814-860-4525
Mailing Address - Fax:
Practice Address - Street 1:117 VIP DR STE 120
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-6934
Practice Address - Country:US
Practice Address - Phone:724-935-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-05311363A00000X, 363AM0700X
PAMA060480363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA060480OtherPENNSYLVANIA STATE BOARD OF MEDICINE
NC1689078776Medicaid
NC0010-05311OtherNORTH CAROLINA MEDICAL BOARD