Individual
GRACEANNE ELIZABETH DATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 HALKET ST, PITTSBURGH, PA 15213-3108
(412) 641-1000
Mailing address
89 BRAMBLE RD, WILLIAMSVILLE, NY 14221-1745
(716) 574-3936
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA067117
PA
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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