Individual
MALLORY KAY RACOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5950 SR 6 FL 4, TUNKHANNOCK, PA 18657
(570) 836-6808
(570) 836-5536
Mailing address
5950 SR 6 FL 4, TUNKHANNOCK, PA 18657-7905
(570) 836-6808
(570) 836-5536
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA054645
PA
363AM0700X
Medical Physician Assistant
OA004422
PA
Other
Enumeration date
09/17/2010
Last updated
09/30/2019
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