Provider Demographics
NPI:1891245486
Name:BARTHELEMY, ANASTASIA (PA-C)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:BARTHELEMY
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 1:104 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-1801
Mailing Address - Country:US
Mailing Address - Phone:724-482-4257
Mailing Address - Fax:724-482-4785
Practice Address - Street 1:100 HAZEL LN STE 100
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1249
Practice Address - Country:US
Practice Address - Phone:412-749-6823
Practice Address - Fax:412-749-6822
Is Sole Proprietor?:No
Enumeration Date:2016-10-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058594363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA058594OtherPA STATE LICENSE