Individual
MRS. MARIE ONUKIAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
846 JEFFERSON AVE, SCRANTON, PA 18510-1032
(570) 342-1047
(570) 558-3962
Mailing address
846 JEFFERSON AVE, SCRANTON, PA 18510-1032
(570) 342-1047
(570) 558-3962
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102405379 0001
PROMISE PROVIDER NUMBER
PA
Enumeration date
05/12/2016
Last updated
05/12/2016
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