Provider Demographics
NPI:1922038470
Name:GILLESPIE, ROBERTA IRENE (PA-C)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:IRENE
Last Name:GILLESPIE
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 1:3459 FIFTH AVENUE
Mailing Address - Street 2:UPMC MONTEFIORE, 7 SOUTH
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15123-2582
Mailing Address - Country:US
Mailing Address - Phone:412-692-2001
Mailing Address - Fax:412-692-2002
Practice Address - Street 1:3459 FIFTH AVENUE
Practice Address - Street 2:UPMC MONTEFIORE, 7 SOUTH
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15123-2582
Practice Address - Country:US
Practice Address - Phone:412-692-2001
Practice Address - Fax:412-692-2002
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA-003017-L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical