Individual
MARISA LYNN CIAMACCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD, MS
Contact information
Practice address
2591 WEXFORD BAYNE RD STE 104, SEWICKLEY, PA 15143
(724) 933-5588
(724) 933-6051
Mailing address
2591 WEXFORD BAYNE RD STE 104, SEWICKLEY, PA 15143-8676
(724) 933-5588
(724) 933-6051
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG003437
PA
152W00000X
Optometrist
TA2583
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103523475
—
PA
Enumeration date
06/29/2017
Last updated
10/10/2018
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