Individual
AMANDA LEIGH DESHISKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-4695
(215) 456-5926
Mailing address
5501 OLD YORK RD, KORMAN SUITE 202, PHILADELPHIA, PA 19141-3018
(215) 456-4695
(215) 456-5926
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS018112
PA
390200000X
Student in an Organized Health Care Education/Training Program
OT014518
PA
Other
Enumeration date
06/11/2012
Last updated
04/05/2016
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