Individual
SAMANTHA LEE BLUE DINTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4815 LIBERTY AVE STE 145, PITTSBURGH, PA 15224-2156
(412) 578-4311
Mailing address
4815 LIBERTY AVE STE 145, PITTSBURGH, PA 15224-2156
(412) 578-4311
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA062849
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15432876
CAQH
—
Enumeration date
05/27/2020
Last updated
01/09/2024
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