Healthcare Provider Details

I. General information

NPI: 1184618563
Provider Name (Legal Business Name): JAMES M JIUNTA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 07/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 MARKET ST
KINGSTON PA
18704-5418
US

IV. Provider business mailing address

417 MARKET ST
KINGSTON PA
18704-5418
US

V. Phone/Fax

Practice location:
  • Phone: 570-287-4200
  • Fax:
Mailing address:
  • Phone: 570-287-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS005598L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: