Healthcare Provider Details

I. General information

NPI: 1982526224
Provider Name (Legal Business Name): CASSIDY BARTKOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 W OLIVE ST
SCRANTON PA
18508-2572
US

IV. Provider business mailing address

3 W OLIVE ST
SCRANTON PA
18508-2572
US

V. Phone/Fax

Practice location:
  • Phone: 570-808-7916
  • Fax:
Mailing address:
  • Phone: 570-808-7916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberSP036567
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP036567
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: