Individual
AMANDA JEANETTE DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
915 BENNER PIKE, STATE COLLEGE, PA 16801-7395
(814) 867-7030
Mailing address
915 BENNER PIKE, STATE COLLEGE, PA 16801-7395
(814) 867-7030
(814) 867-7032
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA055829
PA
363AM0700X
Medical Physician Assistant
MA055829
PA
Other
Enumeration date
11/30/2012
Last updated
07/10/2026
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