Provider Demographics
NPI:1487822573
Name:MARIANNE J. SANTIONI, D.O., PC
Entity Type:Organization
Organization Name:MARIANNE J. SANTIONI, D.O., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SANTIONI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-457-0562
Mailing Address - Street 1:821 S MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:OLD FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:18518-1497
Mailing Address - Country:US
Mailing Address - Phone:570-457-0562
Mailing Address - Fax:
Practice Address - Street 1:821 S MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:OLD FORGE
Practice Address - State:PA
Practice Address - Zip Code:18518-1497
Practice Address - Country:US
Practice Address - Phone:570-457-0562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARIANNE J. SANTIONI, D.O., PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-12
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007763L207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty