Provider Demographics
NPI:1295996254
Name:ERMOL, ALLISON B (PA-C)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:B
Last Name:ERMOL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:RAE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1850 E PARK AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6706
Mailing Address - Country:US
Mailing Address - Phone:814-237-3470
Mailing Address - Fax:814-237-2035
Practice Address - Street 1:1850 E PARK AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803
Practice Address - Country:US
Practice Address - Phone:814-237-3470
Practice Address - Fax:814-237-2035
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052713363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant