Organization
BRADLEY D FENSTER MD PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY D FENSTER MD PHD (OWNER)
(570) 822-6036
Entity
Organization
Contact information
Practice address
107 LOOMIS ST, WILKES BARRE, PA 18702-4637
(570) 822-6036
Mailing address
107 LOOMIS ST, WILKES BARRE, PA 18702-4637
(570) 822-6036
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD073510L
PA
Other
Enumeration date
09/08/2008
Last updated
09/08/2008
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