Provider Demographics
NPI:1487644530
Name:DENINNO, THERESE IRENE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:THERESE
Middle Name:IRENE
Last Name:DENINNO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TRIA
Other - Middle Name:
Other - Last Name:DENINNO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:120 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3000
Mailing Address - Country:US
Mailing Address - Phone:412-427-3390
Mailing Address - Fax:844-978-2756
Practice Address - Street 1:120 5TH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3000
Practice Address - Country:US
Practice Address - Phone:412-427-3390
Practice Address - Fax:844-978-2756
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA050686363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant