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Individual

LISA M MONGIELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
200 MIFFLIN AVE, SCRANTON, PA 18503-1982
(570) 342-3145
(570) 344-1309
Mailing address
2661 RIVA RD STE 1030, ANNAPOLIS, MD 21401-7131
(667) 354-5528

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000231
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001504280
PA
01
081377
FIRST PRIORITY HEALTH
01
15788
GEISINGER HEALTH PLAN
01
410032103
RAILROAD MEDICARE
01
506554
AETNA
01
M0774785
HIGHMARK BLUE SHIELD
Enumeration date
08/13/2006
Last updated
03/25/2026
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