Individual
MR. ERIC FEDUSKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 S 11TH ST STE 8490, PHILADELPHIA, PA 19107-4824
(215) 955-6161
(215) 923-5507
Mailing address
111 S 11TH ST STE 8280, PHILADELPHIA, PA 19107-4824
(215) 955-2370
(215) 955-0677
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS018723
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2013
Last updated
07/08/2019
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