COURTNEY L. FEDOREK PA-C NPI 1063769008

NPI Information

NPI: 1063769008
Provider Name: COURTNEY L. FEDOREK, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
4151 HENDERSON RD
HICKORY, PA
ZIP 15340
Phone: (724) 356-2273
Get Directions

Courtney L. Fedorek, PA-C is a medical physician assistant in Hickory, PA with 12 years of experience. Courtney L. Fedorek, PA-C NPI is 1063769008. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4151 HENDERSON RD
HICKORY, PA
ZIP 15340-439
Phone: (724) 356-2273
Fax: (724) 356-2585

The NPI 1063769008 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/9/2012 and was last updated on 7/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	MA055594	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0195236	MEDICAID	OHIO
2	1031109670001	MEDICAID	PENNSYLVANIA
3	288685RN0	OTHER	PENNSYLVANIA	MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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