Individual
LISA PATHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1592 ROUTE 739, DINGMANS FERRY, PA 18328-3477
(570) 828-8000
(570) 828-6928
Mailing address
1592 ROUTE 739, DINGMANS FERRY, PA 18328-3477
(570) 828-8000
(570) 828-6928
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD423073
PA
208000000X
Pediatrics Physician
MD423073
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019656260004
—
PA
Enumeration date
08/18/2005
Last updated
03/11/2009
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