Provider Demographics
NPI:1710349667
Name:LIMANO, NICHOLAS DAVID (PA-C, MPAS)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:DAVID
Last Name:LIMANO
Suffix:
Gender:M
Credentials:PA-C, MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2945
Mailing Address - Country:US
Mailing Address - Phone:814-333-5503
Mailing Address - Fax:814-333-5925
Practice Address - Street 1:11277 VERNON PL STE 101
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3718
Practice Address - Country:US
Practice Address - Phone:814-333-5503
Practice Address - Fax:814-333-5925
Is Sole Proprietor?:No
Enumeration Date:2016-03-21
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058170363AM0700X
PAOA003769363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical