Individual
DR. SUSANNAH MARIE KISVARDAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6144
(570) 271-6578
Mailing address
100 N ACADEMY AVE # 4903, DANVILLE, PA 17822-9800
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD449910
PA
208000000X
Pediatrics Physician
Primary
291670
MA
208000000X
Pediatrics Physician
MD449910
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2783633515
MYUTMB 2783633515-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
03/11/2025
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