Doctor Name: | ADAM YESENOSKY |
NPI Number: | 1316025315 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | MA052785 |
Business Practice Address: | 5000 Waterdam Plaza Dr Suite 240 Mcmurray, PA - 153175412 |
Business Phone Number: | 7249410111 |
Business Fax Number: | |
Mailing Address: | 5000 Waterdam Plaza Dr, Suite 240 MCMURRAY |
State: | PA |
Postal Code: | 153175412 |
Phone Number: | 7249410111 |
Fax Number: | |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | MA052785 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |