Provider Demographics
NPI:1760210546
Name:VERDE, MARIA LUISA (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LUISA
Last Name:VERDE
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 WYNDHAM DR
Mailing Address - Street 2:
Mailing Address - City:CRESCO
Mailing Address - State:PA
Mailing Address - Zip Code:18326-7447
Mailing Address - Country:US
Mailing Address - Phone:610-216-2716
Mailing Address - Fax:
Practice Address - Street 1:103 N 7TH ST
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-2154
Practice Address - Country:US
Practice Address - Phone:570-726-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001447171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist