| NPI | 1558549733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY JOHN FULCHIERO Owner/Operator/Physician 814-943-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD432947) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA MD432947) |
| 207ND0900X Dermatology, Dermatopathology (Licence: PA MD432947) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: PA MD432947) | |
| Enumeration Date | 2008-02-10 |
| Last Update Date | 2025-01-22 |