Individual
DOROTHY A PERILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
750 E BROAD ST, HAZLETON, PA 18201-6835
(570) 455-6385
Mailing address
750 E BROAD ST, HAZLETON, PA 18201-6835
(570) 455-6385
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA000784L
PA
Other
Enumeration date
10/31/2006
Last updated
05/15/2022
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