Individual
MICHAEL THOMAS CANNIZZARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
700 E BROAD ST, HAZLETON, PA 18201-6835
(570) 501-4193
Mailing address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS022762
PA
Other
Enumeration date
03/28/2020
Last updated
07/17/2023
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