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Individual

DIANA TACELOSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D., PH.D.

Contact information

Practice address
701 W OAK ST, FRACKVILLE, PA 17931-1672
(570) 874-4100
(570) 874-4182
Mailing address
701 W OAK ST, FRACKVILLE, PA 17931-1672
(570) 874-4100
(570) 874-4182

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0116029131
VA
207Q00000X
Family Medicine Physician
Primary
MD482087
PA

Other

Enumeration date
06/15/2016
Last updated
10/19/2024
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