Individual
DR. WITTAWAT KASAYAPANAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
335 S FRANKLIN ST, WILKES BARRE, PA 18702-3808
(570) 825-6425
(570) 829-3337
Mailing address
29 SAND ST, PITTSTON, PA 18640-2609
(570) 332-5348
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD071545L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD071545L
PHYSICIAN LICENSE
PA
Enumeration date
07/08/2006
Last updated
09/26/2007
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