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NPI Code Detail

MEDICARE: ANDERSON FONTALIS

MEDICARE: ANDERSON FONTALIS
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerSP026564PA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerR245785MD
3163W00000XRegistered NurseR245785MD

General Provider Information

NPI Number : 1992476410
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDERSON FONTALIS
Provider Business Mailing Address
First Line : 601 MEMORY LN
Second Line :
City : YORK
State : PA
Zip : 17402-2231
Country : US
Telephone Number : 717-851-1405
Fax Number : 717-851-6969
Provider Business Practice Location Address
First Line : 605 S GEORGE ST STE 100
Second Line :
City : YORK
State : PA
Zip : 17401-3164
Country : US
Telephone Number : 717-356-5060
Fax Number : 717-798-9641
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2021
Last Update Date : 12/08/2025

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Directions to “ ANDERSON FONTALIS ” Practice Location

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