Most Relevant Information
Provider Data
| NPI Number: | 1003562935 |
| Provider Name: | LUCAS CHARLES MARIANO CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | SP025329 |
Most Important Dates
| Enumeration Date: | 03/01/2022 |
| Last Updated: | 07/24/2023 |
Provider Practice Location
740 HIGH ST STE 3002
WILLIAMSPORT
PA
177013102
Practice Location Phone/Fax
| Phone: | 5703212820 |
| Fax: | 5703212821 |
Provider Mailing Location
1201 GRAMPIAN BLVD
WILLIAMSPORT
PA
177011900
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |