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NPI Code Detail

MEDICARE: MISS MARIA TARAMELLI RD LDN

MEDICARE:  MISS MARIA  TARAMELLI  RD LDN
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
1133V00000XRegistered DietitianDN000564PA

General Provider Information

NPI Number : 1558628131
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MARIA TARAMELLI RD LDN
Provider Business Mailing Address
First Line : 801 SCRANTON/CARBONDALE HIGHWAY
Second Line :
City : EYNON
State : PA
Zip : 18403-1020
Country : US
Telephone Number : 570-876-1200
Fax Number : 570-876-1288
Provider Business Practice Location Address
First Line : 801 SCRANTON CARBONDALE HWY
Second Line :
City : EYNON
State : PA
Zip : 18403-1020
Country : US
Telephone Number : 570-876-1200
Fax Number : 570-876-1288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2012
Last Update Date : 04/19/2012

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Directions to “ MISS MARIA TARAMELLI RD LDN” Practice Location

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