Provider Demographics
NPI:1265539977
Name:BASILE, SHERRY (PA-C)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:BASILE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:GASKILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:530 SOUTH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2775
Mailing Address - Country:US
Mailing Address - Phone:724-832-3130
Mailing Address - Fax:724-832-7301
Practice Address - Street 1:530 SOUTH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2775
Practice Address - Country:US
Practice Address - Phone:724-832-3130
Practice Address - Fax:724-832-7301
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052144363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical