Provider Demographics
NPI:1922375443
Name:COYNE, STEPHANIE L (DMS, PA-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:COYNE
Suffix:
Gender:F
Credentials:DMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 DELAFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-1802
Mailing Address - Country:US
Mailing Address - Phone:412-216-2300
Mailing Address - Fax:
Practice Address - Street 1:1010 DELAFIELD RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-1802
Practice Address - Country:US
Practice Address - Phone:412-216-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055334363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant