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Individual

DR. MARIO J SEBASTIANELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1416 MONROE AVE, STE 206, DUNMORE, PA 18509-2477
(570) 347-5212
(570) 346-4814
Mailing address
1416 MONROE AVE, STE 206, DUNMORE, PA 18509-2477
(570) 347-5212
(570) 346-4814

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD0006983E
PA
207RN0300X
Nephrology Physician
ME-11834
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0669080
PA
Enumeration date
07/13/2005
Last updated
08/02/2007
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