Individual
DR. SUSAN LYNN KACZOROWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
25 CHURCH ST, WILKES BARRE, PA 18702-3507
(570) 808-8831
(570) 808-8845
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD044881E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014069690003
—
PA
05
—
2233827
—
OH
05
—
3810000934
—
WV
Enumeration date
08/02/2005
Last updated
07/10/2020
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