Carolyn Marie Witzke, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA051659 Issued in PA

Practice address

1999 Sproul Rd Ste 25
Broomall, PA 19008-3508

Phone

(610) 353-6400

Fax

(610) 356-1836

NPI assigned

Jul 25, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Carolyn Marie Erfle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1982869277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1601",
            "fax_number": "484-337-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 SPROUL RD STE 25",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083508",
            "telephone_number": "610-353-6400",
            "fax_number": "610-356-1836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Parkman St",
            "address_2": "WAC 440",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021143117",
            "country_code": "US",
            "telephone_number": "617-726-8278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITZKE",
        "first_name": "CAROLYN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "ERFLE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Taylor Marie Winslow, MSOT
• Samantha Rose Witte
• Daniel L Wolk, M.D.
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• Mamatha Yeturu, M.D.
• Alison Yez, CRNP

• Medical Physician Assistant in Broomall, PA
• Providers in Broomall, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.