Provider Demographics
NPI: | 1235594805 |
---|---|
Name: | STRITTMATTER, EMILY ROSE (PA-C) |
Entity type: | Individual |
Prefix: | |
First Name: | EMILY |
Middle Name: | ROSE |
Last Name: | STRITTMATTER |
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: | 1200 OLD YORK ROAD |
Mailing Address - Street 2: | |
Mailing Address - City: | ABINGTON |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 19001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 711-468-2850 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1200 OLD YORK ROAD |
Practice Address - Street 2: | ABINGTON EMERGENCY PHYSICIAN ASSOCIATES |
Practice Address - City: | ABINGTON |
Practice Address - State: | PA |
Practice Address - Zip Code: | 19001 |
Practice Address - Country: | US |
Practice Address - Phone: | 215-481-4355 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2015-12-23 |
Last Update Date: | 2018-03-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | MA059095 | 207P00000X, 363AM0700X |
390200000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |