Individual
MS. DIANE E RADVANSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7337
(215) 456-7375
Mailing address
1980 SUPPLEE RD, LANSDALE, PA 19446-5563
(215) 456-7337
(215) 456-7375
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
VP005392-B
PA
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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