Individual
MAUREEN KIELAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
78 SALEM AVE, CARBONDALE, PA 18407-2004
(570) 282-2000
Mailing address
78 SALEM AVE, CARBONDALE, PA 18407-2004
(570) 282-2000
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KI211041
BLUE CROSS BLUE SHIELD
PA
Enumeration date
12/12/2007
Last updated
12/12/2007
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