Provider Demographics
NPI:1215675822
Name:DILORETO, KRISTY M (GC)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:M
Last Name:DILORETO
Suffix:
Gender:F
Credentials:GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WESNER LN # MC24-80
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-8023
Mailing Address - Country:US
Mailing Address - Phone:570-214-2637
Mailing Address - Fax:
Practice Address - Street 1:15 WESNER LN # MC24-80
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-8023
Practice Address - Country:US
Practice Address - Phone:570-214-2637
Practice Address - Fax:570-214-7342
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS