Individual
VIOLETA MARINA LIZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 SMALLACOMBE DR, SCRANTON, PA 18508-2616
(570) 961-0171
(570) 207-2411
Mailing address
201 SMALLACOMBE DR, SCRANTON, PA 18508-2616
(570) 961-0171
(570) 207-2411
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD042939E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011492900005
—
PA
05
—
0011492900007
—
PA
01
—
MD042939E
STATE LICENSE
PA
Enumeration date
12/12/2006
Last updated
07/09/2007
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