Provider Demographics
NPI:1205277126
Name:SHONTZ, BROOKE LEE ZDROSKY (PA-C)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:LEE ZDROSKY
Last Name:SHONTZ
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 1:10663 RAYSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-7542
Mailing Address - Country:US
Mailing Address - Phone:814-627-0071
Mailing Address - Fax:
Practice Address - Street 1:10663 RAYSTOWN RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-7542
Practice Address - Country:US
Practice Address - Phone:814-627-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant