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Individual

DR. ROSEANN MARIE RUPP-MAIOLATESI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
117 LACKAWANNA AVE, OLYPHANT, PA 18447-1449
(570) 383-9601
(570) 383-9613
Mailing address
42 SPRING ST, CARBONDALE, PA 18407-2027
(570) 281-3332

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OE-007219-T
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014136220003
PA
01
075223
FIRST PRIORITY HEALTH
PA
01
22504
GEISINGER
PA
01
396606
NVA
PA
01
736553
US HEALTH CARE
PA
Enumeration date
01/04/2007
Last updated
07/08/2007
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