Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | MD07161L | PA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD071651L | PA |
NPI | 1265408470 |
---|---|
Provider Name | George Yesenosky |
First Address | Philadelphia, PA 19129-1302 |
Second Address | Philadelphia, PA 19140-4105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 07/03/2016 |