Provider Demographics
NPI:1942981899
Name:SROMOSKI, MARYANN (FNP)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:SROMOSKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8487 PUTNAM CT
Mailing Address - Street 2:
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031-1582
Mailing Address - Country:US
Mailing Address - Phone:570-328-0374
Mailing Address - Fax:
Practice Address - Street 1:8487 PUTNAM CT
Practice Address - Street 2:
Practice Address - City:BREINIGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18031-1582
Practice Address - Country:US
Practice Address - Phone:570-328-0374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAFO7230552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily