Individual
LIANA M THEROUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-1098
(570) 271-6012
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
299802
NY
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
MD470312
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2014
Last updated
10/19/2020
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