Individual
CARLA K MARISCOTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2 BRIARCREST SQ, HERSHEY, PA 17033-2359
(717) 533-2362
(717) 534-2357
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000191
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01816701
BLUE CROSS
—
01
—
434111
BLUE SHIELD
—
Enumeration date
09/02/2005
Last updated
11/04/2022
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