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General NPI Number Information
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NPI Number | 1992476410
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Entity Type | Individual
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Provider Name | ANDERSON FONTALIS
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Gender | Male
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Dates
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Enumeration Date | 09/23/2021
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 605 S GEORGE ST STE 100
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City | YORK
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State | PA
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Zip | 17401-3164
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Country | US
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Telephone | 717-356-5060
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Fax | 717-798-9641
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Provider Business Mailing Address
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Address Line | 601 MEMORY LN
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City | YORK
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State | PA
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Zip | 17402-2231
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Country | US
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Telephone | 717-851-1405
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Fax | 717-851-6969
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP026564
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R245785
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R245785
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License Number State | MD
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