Individual
ANTHONY LUISTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 W LEHIGH AVE STE A, PHILADELPHIA, PA 19132-2760
(215) 226-8800
(215) 226-8819
Mailing address
2450 W. HUNTING PARK AVENUE, 2ND FLOOR, TPI-CBO, PHILADELPHIA, PA 19129-1302
(215) 926-9010
(215) 226-8285
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD432474
PA
Other
Enumeration date
01/25/2008
Last updated
03/16/2021
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