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General NPI Number Information
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NPI Number | 1548066871
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Entity Type | Individual
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Provider Name | THOMAS JOSEPH VISSARI CRNP
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Gender | Male
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 100 HOSPITAL AVE
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City | DU BOIS
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State | PA
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Zip | 15801-1440
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Country | US
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Telephone | 814-371-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 123 REO ST APT A
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City | BUTLER
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State | PA
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Zip | 16001-4628
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Country | US
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Telephone | 724-996-2194
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP031949
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License Number State | PA
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