Individual
ANTHONY NIESCIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
700 DEKALB ST, BRIDGEPORT, PA 19405-1149
(610) 277-6200
(610) 277-3437
Mailing address
1 W ELM ST, SUITE 100, CONSHOHOCKEN, PA 19428-4108
(610) 567-6967
(610) 567-6955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS003522L
PA
208D00000X
General Practice Physician
OS003522L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006785520003
—
PA
01
—
232515999
TAX ID
PA
Enumeration date
09/12/2005
Last updated
02/23/2012
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