Individual
MR. ANTHONY YAROSLAV FISUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
2008 PRESIDENT ST, PHILADELPHIA, PA 19115-2607
(215) 200-0420
Mailing address
2008 PRESIDENT ST, PHILADELPHIA, PA 19115-2607
(215) 200-0420
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
SP014633
PA
363LG0600X
Gerontology Nurse Practitioner
Primary
SP014633
PA
Other
Enumeration date
05/04/2015
Last updated
12/09/2015
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