Omalley, Miriam Caroline
Omalley, Miriam Caroline is an individual health care provider with primary practice located at 550 3Rd Ave Ste 1, Kingston PA 18704-5806. She recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as her primary health care specialty. Omalley, Miriam Caroline can be contacted via phone (570) 288-9070.Contact Information
Primary practice address
550 3Rd Ave Ste 1
Kingston PA 18704-5806
Phone: (570) 288-9070
Fax: (570) 288-4201
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 027676L | Pennsylvania |
Profile Details
| NPI number | 1154419042 |
|---|---|
| LBN Legal business name | Omalley, Miriam Caroline |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Oct 10th, 2013 - about 11 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 | 1154419042 | NPPES |
| Pennsylvania | MEDICAID | 01696297 |
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