Healthcare Provider Details

I. General information

NPI: 1356458574
Provider Name (Legal Business Name): DARLENE ANN DUNAY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 OAK ST
OLD FORGE PA
18518-1619
US

IV. Provider business mailing address

314 OAK ST
OLD FORGE PA
18518-1619
US

V. Phone/Fax

Practice location:
  • Phone: 570-457-7150
  • Fax: 570-457-8611
Mailing address:
  • Phone: 570-457-7150
  • Fax: 570-457-8611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS005374-L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier10017190001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: