Individual
ILEANA PANEBIANCO BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1020 FRANKLIN ST, JOHNSTOWN, PA 15905-4109
(814) 534-9132
Mailing address
3449 MENOHER BLVD, JOHNSTOWN, PA 15905-5503
(814) 248-9792
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA060976
PA
Other
Enumeration date
10/17/2019
Last updated
08/15/2024
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