| Crystal St Fort, NP | |
|
142 S 60th St Unit A, Philadelphia, PA 19139-3038 | |
| (215) 495-5846 | |
| Not Available |
| Full Name | Crystal St Fort |
|---|---|
| Gender | Female |
| Speciality | Dermatology - Procedural Dermatology |
| Location | 142 S 60th St Unit A, Philadelphia, Pennsylvania |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871341073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207NS0135X | Dermatology - Procedural Dermatology | SP029428 (Pennsylvania) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal St Fort, NP 142 S 60th St Unit A, Philadelphia, PA 19139-3038 Ph: (215) 495-5846 | Crystal St Fort, NP 142 S 60th St Unit A, Philadelphia, PA 19139-3038 Ph: (215) 495-5846 |
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