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Individual
SUZANNE FISCELLA
Active
Individual
SUZANNE FISCELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1028
KY
363A00000X
Physician Assistant
Primary
PA9105008
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000692903
ANTHEM
KY
05
—
015456400
—
FL
05
—
7100013900
—
KY
01
—
P00428292
RAILROAD MEDICARE
KY
Enumeration date
02/22/2007
Last updated
03/25/2021
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