Provider Demographics
NPI:1740350040
Name:CHERRONE, JAMIE M (PA-C)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:M
Last Name:CHERRONE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4815 LIBERTY AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-235-5900
Mailing Address - Fax:412-235-5901
Practice Address - Street 1:4815 LIBERTY AVE STE 215
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-235-5900
Practice Address - Fax:412-235-5901
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051138363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103146324Medicaid
295873Medicare PIN