Provider Demographics
NPI:1013006634
Name:PATRONAS, WENDY A (PA-C)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:A
Last Name:PATRONAS
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 1:800 PLAZA DR
Mailing Address - Street 2:STE 240
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-4019
Mailing Address - Country:US
Mailing Address - Phone:724-379-5816
Mailing Address - Fax:724-379-5874
Practice Address - Street 1:800 PLAZA DR
Practice Address - Street 2:STE 240
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-4019
Practice Address - Country:US
Practice Address - Phone:724-379-5816
Practice Address - Fax:724-379-5874
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA050982363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
064224F4DMedicare PIN
PAP72051Medicare UPIN
PA064224FMNMedicare ID - Type Unspecified