Provider Demographics
NPI:1942238092
Name:STARSINIC, TRACI LYNN (PAC)
Entity Type:Individual
Prefix:MRS
First Name:TRACI
Middle Name:LYNN
Last Name:STARSINIC
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MS
Other - First Name:TRACI
Other - Middle Name:LYNN
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2112 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3500
Mailing Address - Fax:717-544-3501
Practice Address - Street 1:2112 HARRISBURG PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3500
Practice Address - Fax:717-544-3501
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051035363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA051035OtherLICENSE
P00659396OtherMEDICARE RAIL RAILROAD CARRIER
P00659396OtherMEDICARE RAIL RAILROAD CARRIER
PA224725JW2Medicare PIN
MG1241784OtherDEA