| Doctor Name: | MARY KATHERINE MACALUSO |
| NPI Number: | 1851676985 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | MA055335 |
| Business Practice Address: | 224 North Logan Blvd., Ste. 220 Burnham, PA - 170094510 |
| Business Phone Number: | 7172420196 |
| Business Fax Number: | 7172420701 |
| Mailing Address: | 100 N Academy Ave, DANVILLE |
| State: | PA |
| Postal Code: | 178224903 |
| Phone Number: | 5702716144 |
| Fax Number: | |
| NPI Enumeration Date: | 10/20/2011 |
| NPI Last Update Date: | 05/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA055335 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |