Provider Demographics
NPI:1851026272
Name:MARIANI, MARIA MADDALENA (PA-C)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:MADDALENA
Last Name:MARIANI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CHERRY TREE PL
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-1124
Mailing Address - Country:US
Mailing Address - Phone:412-522-5111
Mailing Address - Fax:
Practice Address - Street 1:1500 VILLAGE RUN RD STE 308
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-6316
Practice Address - Country:US
Practice Address - Phone:724-934-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA063754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA063754OtherPENNSYLVANIA BOARD OF MEDICINE