Provider Demographics
NPI:1558398826
Name:VEGLIA, KATHLEEN S (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:S
Last Name:VEGLIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1525 N CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18202-9383
Mailing Address - Country:US
Mailing Address - Phone:570-454-5222
Mailing Address - Fax:570-454-5967
Practice Address - Street 1:1525 N CHURCH STREET
Practice Address - Street 2:
Practice Address - City:HAZLE TWP
Practice Address - State:PA
Practice Address - Zip Code:18202-9383
Practice Address - Country:US
Practice Address - Phone:570-454-5222
Practice Address - Fax:570-454-5967
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD031654E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
072454OtherFIRST PRIORITY OF NEPA
PA0011228860003Medicaid
PA0011228860003Medicaid
PA167878Medicare PIN