Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MD474759 | PA |
NPI | 1033663976 |
---|---|
Provider Name | Jeff Hosry |
First Address | Danville, PA 17822-4903 |
Second Address | Wilkes Barre, PA 18702-7900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2016 |
Last Update Date | 13/09/2021 |