Provider Demographics
NPI:1831475920
Name:GROSCOST, AUTUMN (PA-C)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:GROSCOST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:
Other - Last Name:AUL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1050 BOWER HILL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1866
Mailing Address - Country:US
Mailing Address - Phone:412-572-6164
Mailing Address - Fax:412-572-6156
Practice Address - Street 1:1050 BOWER HILL RD STE 101
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1866
Practice Address - Country:US
Practice Address - Phone:412-572-6164
Practice Address - Fax:412-572-6156
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055313363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical