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NPI Code Detail

MEDICARE: DR. JOSEPH M MUCCIOLO JR. MD

MEDICARE: DR. JOSEPH M MUCCIOLO JR. MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery PhysicianMD067194LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447228366
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH M MUCCIOLO JR. MD
Provider Business Mailing Address
First Line : 1 HOSPITAL DR
Second Line : SUITE 306
City : LEWISBURG
State : PA
Zip : 17837-9350
Country : US
Telephone Number : 570-522-4110
Fax Number : 570-768-3911
Provider Business Practice Location Address
First Line : 25 LYSTRA ROGERS DR
Second Line :
City : LEWISBURG
State : PA
Zip : 17837-8807
Country : US
Telephone Number : 570-523-3290
Fax Number : 570-524-5231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 06/09/2022

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