Alexander V. Mezentsev PA-C

NPI 1780988766 - Physician Assistant - 363A00000X

NPI Details
NPI 1780988766
Gender Male
Enumeration Date 01/05/2011
Last Updated 01/05/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
780 BROAD ST
STE 4
MONTOURSVILLE PA, 17754-2419, US
Phone (570) 368-2870
Fax (570) 368-4463
Business Location
100 N ACADEMY AVE
CREDENTIALS DEPT
DANVILLE PA, 17822-4903, US
Phone (570) 271-6144
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Pennsylvania
License Number MA054663
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According to our database, Mr. Alexander V. Mezentsev PA-C NPI is 1780988766, taxonomy code is 363A00000X and license number is MA054663, license state is located at Pennsylvania. Alexander V. Mezentsev PA-C physically located at 780 Broad St, Montoursville PA, 17754-2419. NPI Number Alexander V. Mezentsev PA-C has the Individual type.

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1780988766 NPI number is provided on an as is basis without warranty of any kind. 1780988766 is maintained by the National Plan & Provider Enumeration System. The contents of Alexander V. Mezentsev PA-C are for informational purposes only.