Individual
MARY JANE DALLASTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
RR 1 BOX 64B, BUTTERFIELD ROAD, SUSQUEHANNA, PA 18847-9751
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN510-504L
PA
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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