Individual
MS. HEATHER D LETCAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
149 LAFAYETTE AVE, TAMAQUA, PA 18252-4619
(702) 899-0595
(702) 977-1496
Mailing address
PO BOX 74008272, CHICAGO, IL 60674-8272
(702) 899-0595
(702) 977-1496
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA051716
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1077031
CERTIFICATION NUMBER
PA
Enumeration date
09/19/2007
Last updated
10/02/2025
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