Provider Demographics
NPI:1740419589
Name:HOLTZ, ERIC ANTHONY (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ANTHONY
Last Name:HOLTZ
Suffix:
Gender:M
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 1:7000 STONEWOOD DR
Mailing Address - Street 2:STE 151
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7376
Mailing Address - Country:US
Mailing Address - Phone:724-933-0300
Mailing Address - Fax:724-933-0456
Practice Address - Street 1:7000 STONEWOOD DR
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7376
Practice Address - Country:US
Practice Address - Phone:724-933-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053859363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant