Individual
PETER V KOSTISHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 243-1455
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN619948
PA
363L00000X
Nurse Practitioner
Primary
SP019244
PA
Other
Enumeration date
07/11/2018
Last updated
09/12/2018
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