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General NPI Number Information
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NPI Number | 1053453118
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Entity Type | Individual
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Provider Name | ANITA FRANCINE ADSHEAD PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 BROOKDALE PLAZA
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City | BROOKLYN
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State | NY
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Zip | 11212
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Country | US
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Telephone | 718-240-5000
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Fax |
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Provider Business Mailing Address
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Address Line | RR1-BOX1790A
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City | KUNKLETOWN
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State | PA
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Zip | 18058
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Country | US
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Telephone | 570-620-9192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 003275-01
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License Number State | NY
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