Individual
MS. STEPHANIE KATARINA PETSCHAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
334 MAIN ST, DICKSON CITY, PA 18519-1668
(570) 307-1767
Mailing address
1605 N CEDAR CREST BLVD STE 411, ALLENTOWN, PA 18104-2323
(484) 629-2282
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MA0619857
PA
363AS0400X
Surgical Physician Assistant
Primary
MA0619857
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA061857
STATE LICENSE
PA
Enumeration date
09/20/2020
Last updated
03/24/2025
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