Provider Demographics
NPI:1457801243
Name:CHAFFO, AMANDA LEE (PA-C, ATC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:CHAFFO
Suffix:
Gender:F
Credentials:PA-C, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3362 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1450
Mailing Address - Country:US
Mailing Address - Phone:724-325-1301
Mailing Address - Fax:
Practice Address - Street 1:3362 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1450
Practice Address - Country:US
Practice Address - Phone:724-325-1301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer