MEDICARE: CASSANDRA LYNN TUNIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS017630	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619234002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA LYNN TUNIS

Provider Business Mailing Address
First Line	:	100 N ACADEMY AVE
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17822-4903
Country	:	US
Telephone Number	:	570-271-6144
Fax Number	:

Provider Business Practice Location Address
First Line	:	42 NORTH MAIN STREET
Second Line	:
City	:	PITTSTON
State	:	PA
Zip	:	18640-3844
Country	:	US
Telephone Number	:	570-654-0880
Fax Number	:	570-655-9857

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2012
Last Update Date	:	08/13/2020

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Directions to “ CASSANDRA LYNN TUNIS ” Practice Location

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