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Individual

DIANE WENTLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
314 E NORTH AVE, LEVEL ONE, PITTSBURGH, PA 15212-4756
(412) 325-5700
Mailing address
314 EAST NORTH AVENUE, LEVEL ONE, PITTSBURGH, PA 15212-4756
(412) 325-5500

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004536
NY
363A00000X
Physician Assistant
Primary
MA054463
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002723161
HIGHMARK MEDICARE ADVANTAGE
PA
05
103187944
PA
01
PO1714755
RAILROAD MEDICARE
PA
Enumeration date
12/15/2005
Last updated
10/20/2020
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