Individual
KARLA GRACE DALIOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3 WEST OLIVE ST., SCRANTON, PA 18508-3805
(570) 207-4054
(570) 207-4057
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
017107
NY
363A00000X
Physician Assistant
Primary
MA058006
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
474364
MEDICARE
PA
Enumeration date
10/10/2013
Last updated
12/21/2020
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