Basic Information
| Provider Information | |||||||||
| NPI: | 1477221711 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZITALONE | ||||||||
| FirstName: | MARAH | ||||||||
| MiddleName: | STAR | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1020 SPRUCE TREE DR | ||||||||
| Address2: | |||||||||
| City: | GIRARD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 164171262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144505046 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2315 MYRTLE ST STE 190 | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165024604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144537767 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2021 | ||||||||
| LastUpdateDate: | 09/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.