Individual
CATHERINE PANDISCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9555 UPLAND LN N, MAPLE GROVE, MN 55369-4485
(952) 831-8742
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10060
MN
363AS0400X
Surgical Physician Assistant
10060
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
682432300
—
MN
Enumeration date
07/03/2006
Last updated
04/05/2024
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