Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD463785 | PA |
N | 207KA0200X | Allergist | D0079508 | MD |
N | 207KA0200X | Allergist | MD463785 | PA |
NPI | 1235441999 |
---|---|
Provider Name | Larisa Buyantseva Fritz |
First Address | Mechanicsburg, PA 17050-8268 |
Second Address | Mechanicsburg, PA 17050 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2010 |
Last Update Date | 19/12/2020 |