Liberatore, Tracy Lynn
Liberatore, Tracy Lynn is an individual health care provider with primary practice located at 150 Mundy St , Wilkes Barre PA 18702-6830. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Liberatore, Tracy Lynn can be contacted via phone (570) 824-0930.Contact Information
Primary practice address
150 Mundy St
Wilkes Barre PA 18702-6830
Phone: (570) 824-0930
Fax: (570) 824-7755
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | MA051327 | Pennsylvania |
Profile Details
| NPI number | 1396878922 |
|---|---|
| LBN Legal business name | Liberatore, Tracy Lynn |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 13th, 2007 |
| Last updated | Feb 5th, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396878922 | NPPES |
| Pennsylvania | Other | P00388511 | RAILROAD MEDICARE |
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