Organization
MARIO J. SEBASTIANELLI, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO J. SEBASTIANELLI M.D. (OWNER)
(570) 347-5212
Entity
Organization
Contact information
Practice address
1416 MONROE AVE, STE 206, DUNMORE, PA 18509-2477
(570) 347-5212
(570) 346-4814
Mailing address
1416 MONROE AVE, STE 206, DUNMORE, PA 18509-2477
(570) 347-5212
(570) 346-4814
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD006983E
PA
207RN0300X
Nephrology Physician
Primary
MD006983E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0669080
—
PA
Enumeration date
07/13/2005
Last updated
08/06/2007
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