Individual
DR. KATHRYN ANN SALLAVANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
315 S MAIN ST, OLD FORGE, PA 18518-1606
(570) 457-8364
(570) 457-9635
Mailing address
315 S MAIN ST, OLD FORGE, PA 18518-1606
(570) 457-8364
(570) 457-9635
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS016121
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027430260001
—
PA
Enumeration date
03/12/2009
Last updated
10/27/2021
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