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General NPI Number Information
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NPI Number | 1033280417
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Entity Type | Individual
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Provider Name | DEBORAH J. MISTAL DO
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Gender | Female
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 04/03/2013
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Provider Practice Location Address
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Address Line | 32 WEST FOOTHILLS DRIVE
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City | DRUMS
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State | PA
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Zip | 18222
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Country | US
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Telephone | 570-788-5000
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Fax | 570-788-2325
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Provider Business Mailing Address
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Address Line | PO BOX 1347
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City | KINGSTON
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State | PA
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Zip | 18704-0347
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Country | US
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Telephone | 570-288-8881
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Fax | 570-288-8065
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS005335L
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License Number State | PA
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