Provider Demographics
NPI:1932589371
Name:MACIO, INGRID (PA-C)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:MACIO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:INGRID
Other - Middle Name:
Other - Last Name:MACIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:300 HALKET STREET, ROOM 5526
Mailing Address - Street 2:MAGEE-WOMENS HOSPITAL OF UPMC
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:412-641-5455
Mailing Address - Fax:412-641-2319
Practice Address - Street 1:300 HALKET STREET, ROOM 5526
Practice Address - Street 2:MAGEE-WOMENS HOSPITAL OF UPMC
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213
Practice Address - Country:US
Practice Address - Phone:412-641-5455
Practice Address - Fax:412-641-2319
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001104L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant