Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 111NX0100X | PA |
NPI | 1659918142 |
---|---|
Provider Name | Yaroslav Fedyk |
First Address | Doylestown, PA 18902-1901 |
Second Address | Doylestown, PA 18902-1901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2019 |
Last Update Date | 04/12/2019 |