Healthcare Provider Details

I. General information

NPI: 1275450660
Provider Name (Legal Business Name): MARGARET BLASETTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N FAIRVIEW ST
LOCK HAVEN PA
17745-2342
US

IV. Provider business mailing address

225 NAVAJO DR
RED LION PA
17356-9646
US

V. Phone/Fax

Practice location:
  • Phone: 717-415-8192
  • Fax:
Mailing address:
  • Phone: 717-415-8192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: