Provider Demographics
NPI:1912739137
Name:RUPERT, GIANA PEARLE
Entity type:Individual
Prefix:
First Name:GIANA
Middle Name:PEARLE
Last Name:RUPERT
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 1:14 BLUE JAY DR
Mailing Address - Street 2:
Mailing Address - City:WATSONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17777-9734
Mailing Address - Country:US
Mailing Address - Phone:570-428-2270
Mailing Address - Fax:
Practice Address - Street 1:1722 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1285
Practice Address - Country:US
Practice Address - Phone:570-435-8180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health