Nissley, Jay Marlin
Nissley, Jay Marlin is an individual health care provider with primary practice located at 55 Medical Park Dr , Lewisburg PA 17837-6343. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Nissley, Jay Marlin can be contacted via phone (570) 523-3264.Contact Information
Primary practice address
55 Medical Park Dr
Lewisburg PA 17837-6343
Phone: (570) 523-3264
Fax: (570) 523-3465
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD011004E | Pennsylvania |
Profile Details
| NPI number | 1215924345 |
|---|---|
| LBN Legal business name | Nissley, Jay Marlin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2005 |
| Last updated | Nov 10th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215924345 | NPPES |
| Pennsylvania | MEDICAID | 0008831050003 |
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