Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MA060505 | PA |
NPI | 1043874092 |
---|---|
Provider Name | Sasha Alex Volynsky |
First Address | Philadelphia, PA 19104-4238 |
Second Address | Philadelphia, PA 19104-4238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2019 |
Last Update Date | 25/04/2019 |