Healthcare Provider Details

I. General information

NPI: 1750332979
Provider Name (Legal Business Name): MARIA HUTSKO RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 01/15/2021
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 OLD RIVER RD
WILKES BARRE PA
18702-1611
US

IV. Provider business mailing address

250 OLD RIVER RD
WILKES BARRE PA
18702-1611
US

V. Phone/Fax

Practice location:
  • Phone: 570-822-5794
  • Fax:
Mailing address:
  • Phone: 570-822-5794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP036048L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: