Individual
MRS. KELLY L MARSICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MHS
Contact information
Practice address
746 JEFFERSON AVE, SCRANTON, PA 18510-1624
(570) 770-3100
(570) 963-5631
Mailing address
746 JEFFERSON AVE, SCRANTON, PA 18510-1624
(570) 770-3100
(570) 963-5631
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA053999
PA
363AM0700X
Medical Physician Assistant
OA002907
PA
Other
Enumeration date
09/03/2009
Last updated
10/21/2019
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