Provider Demographics
NPI:1013669795
Name:JANKOWSKI, KEITH ANDREW (PA-C)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:ANDREW
Last Name:JANKOWSKI
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 1:914 PAINTER AVE
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-2446
Mailing Address - Country:US
Mailing Address - Phone:412-849-5037
Mailing Address - Fax:
Practice Address - Street 1:914 PAINTER AVE
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2446
Practice Address - Country:US
Practice Address - Phone:412-849-5037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant