Individual
RYAN ANTHONY FISICARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 PUNCHBOWL ST, HONOLULU, HI 96813-2499
(808) 691-1000
Mailing address
5501 OLD YORK RD, ALBERT EINSTEIN MEDICAL CENTER, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD24354
HI
390200000X
Student in an Organized Health Care Education/Training Program
MT211183
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT211183
MEDICAL TRAINING LICENSE NUMBER
PA
Enumeration date
06/16/2016
Last updated
06/17/2024
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