Doctor Name: | ANTHONY NIESCIER |
NPI Number: | 1720073299 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | OS003522L |
Business Practice Address: | 700 Dekalb St Bridgeport, PA - 194051149 |
Business Phone Number: | 6102776200 |
Business Fax Number: | 6102773437 |
Mailing Address: | 1 W Elm St, Suite 100 CONSHOHOCKEN |
State: | PA |
Postal Code: | 194284108 |
Phone Number: | 6105676967 |
Fax Number: | 6105676955 |
NPI Enumeration Date: | 09/12/2005 |
NPI Last Update Date: | 02/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OS003522L |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |