Individual
ANESTI GIANITSOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2301 S BROAD ST, PHILADELPHIA, PA 19148-3542
(215) 952-9323
(215) 952-1246
Mailing address
2301 S BROAD ST, PHILADELPHIA, PA 19148-3542
(717) 263-5562
(717) 263-1566
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS007174L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014121890001
—
PA
Enumeration date
09/30/2005
Last updated
02/21/2020
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