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NPI Code Detail

MEDICARE: DR. KAYLA ELIZABETH FRESCO MD

MEDICARE: DR. KAYLA ELIZABETH FRESCO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD489952PA

General Provider Information

NPI Number : 1053053645
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAYLA ELIZABETH FRESCO MD
Provider Business Mailing Address
First Line : 1700 S LINCOLN AVE
Second Line :
City : LEBANON
State : PA
Zip : 17042-7529
Country : US
Telephone Number : 717-272-6621
Fax Number :
Provider Business Practice Location Address
First Line : 1700 S LINCOLN AVE
Second Line :
City : LEBANON
State : PA
Zip : 17042-7529
Country : US
Telephone Number : 717-272-6621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2022
Last Update Date : 02/03/2026

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