Individual
KATHRYN M FOSSACECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
545 S ANN ST, LANCASTER, PA 17602-4551
(717) 299-6371
Mailing address
812 N PRINCE ST, LANCASTER, PA 17603-2732
(717) 299-6371
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA062000
PA
363AM0700X
Medical Physician Assistant
OA005390
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103840042
—
PA
Enumeration date
10/29/2020
Last updated
04/24/2023
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