Provider Demographics
NPI:1295102523
Name:DIAMOND, LINDA K (PA-C)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:DIAMOND
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 1:1 WOODS PL
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1833
Mailing Address - Country:US
Mailing Address - Phone:412-359-8351
Mailing Address - Fax:
Practice Address - Street 1:490 E NORTH AVE STE 515
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4780
Practice Address - Country:US
Practice Address - Phone:412-681-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001575L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
15018558OtherCAQH