Lizano, Violeta Marina

Lizano, Violeta Marina is an individual health care provider with primary practice located at 201 Smallacombe Dr , Scranton PA 18508-2616. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Lizano, Violeta Marina can be contacted via phone (570) 961-0171.

Contact Information

Primary practice address
201 Smallacombe Dr Scranton PA 18508-2616
Phone: (570) 961-0171
Fax: (570) 207-2411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD042939E Pennsylvania

Profile Details

NPI number 1164583613
LBN Legal business name Lizano, Violeta Marina
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Jul 9th, 2007 - about 17 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 1164583613 NPPES
Pennsylvania Other MD042939E STATE LICENSE
Pennsylvania MEDICAID 0011492900005 STATE LICENSE
Pennsylvania MEDICAID 0011492900007 STATE LICENSE

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