Provider Demographics
NPI:1912435322
Name:MARUCA, AMBER ROSE
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:ROSE
Last Name:MARUCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CRESSON
Mailing Address - State:PA
Mailing Address - Zip Code:16630-1141
Mailing Address - Country:US
Mailing Address - Phone:814-534-9000
Mailing Address - Fax:
Practice Address - Street 1:815 2ND ST
Practice Address - Street 2:
Practice Address - City:CRESSON
Practice Address - State:PA
Practice Address - Zip Code:16630-1141
Practice Address - Country:US
Practice Address - Phone:814-215-3492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant