Individual
DR. LISA ANNE MUCCIOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
80 MEDICAL PARK DR, LEWISBURG, PA 17837-6343
(570) 768-4646
(570) 768-4648
Mailing address
1 HOSPITAL DR STE 306, LEWISBURG, PA 17837-9350
(570) 522-4110
(570) 768-3911
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD067434L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017494250005
—
PA
Enumeration date
08/19/2005
Last updated
06/09/2022
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