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General NPI Number Information
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NPI Number | 1669884607
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Entity Type | Individual
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Provider Name | KEVIN MUSTO M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2014
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 1099 S TOWNSHIP BLVD
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City | PITTSTON
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State | PA
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Zip | 18640-3247
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Country | US
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Telephone | 570-602-2400
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Fax | 570-602-8054
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Provider Business Mailing Address
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Address Line | 1099 S TOWNSHIP BLVD
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City | PITTSTON
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State | PA
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Zip | 18640-3247
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Country | US
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Telephone | 570-602-2400
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD460985
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License Number State | PA
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