Ditullio, Mary Kathleen

Ditullio, Mary Kathleen is an individual health care provider with primary practice located at 17 Merline Ave , Erie PA 16509-1567. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Ditullio, Mary Kathleen can be contacted via phone (814) 868-9484.

Contact Information

Primary practice address
17 Merline Ave Erie PA 16509-1567
Phone: (814) 868-9484
Fax: (814) 866-5904
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X VP003581G Pennsylvania

Profile Details

NPI number 1053304998
LBN Legal business name Ditullio, Mary Kathleen
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2005
Last updated Apr 16th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053304998 NPPES
Pennsylvania Other 1988988 BLUE SHIELD
Pennsylvania Other 1565773 BLUE SHIELD
Pennsylvania Other P00406374 BLUE SHIELD

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