Individual
LUCAS CHARLES MARIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
740 HIGH ST STE 3002, WILLIAMSPORT, PA 17701-3102
(570) 321-2820
(570) 321-2821
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP025329
PA
Other
Enumeration date
03/01/2022
Last updated
07/24/2023
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