Provider Demographics
NPI:1205186046
Name:KRETCHEK, ALLISON C (PA-C)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:C
Last Name:KRETCHEK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:C
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7500 BROOKTREE RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9254
Mailing Address - Country:US
Mailing Address - Phone:412-367-0600
Mailing Address - Fax:412-367-7079
Practice Address - Street 1:7500 BROOKTREE RD
Practice Address - Street 2:SUITE 302
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9254
Practice Address - Country:US
Practice Address - Phone:412-367-0600
Practice Address - Fax:412-367-7079
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055798363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical