=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942318431
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUDMILA ARONZON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/26/2006
-----------------------------------------------------
Last Update Date | 03/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 175 S WILKES BARRE BLVD
-----------------------------------------------------
City | WILKES BARRE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18702-5040
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-829-2621
-----------------------------------------------------
Fax | 570-823-4332
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 N ACADEMY AVE # 4903
-----------------------------------------------------
City | DANVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17822-9800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-271-6144
-----------------------------------------------------
Fax | 570-271-6578
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | MA051986
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------