Provider Demographics
NPI:1992851554
Name:ESPINAL, FANNY ESTELA (MD)
Entity Type:Individual
Prefix:
First Name:FANNY
Middle Name:ESTELA
Last Name:ESPINAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-4240
Mailing Address - Fax:717-848-5520
Practice Address - Street 1:2050 S QUEEN ST
Practice Address - Street 2:STE 100
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4829
Practice Address - Country:US
Practice Address - Phone:717-812-4240
Practice Address - Fax:717-848-5520
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430514208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1938014OtherHIGHMARK BLUE SHIELD
PA30123099 - DOVEROtherAMERIHEALTH MERCY - WMG
PA418791OtherUPMC
PAP008312OtherGATEWAY
PA30123100 - YORKOtherAMERIHEALTH MERCY - WMG
PA30123099 - DOVEROtherAMERIHEALTH MERCY - WMG
PA418791OtherUPMC