| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CHRISTINE LUDA GORDYNSKIY-AGEYEV | 1902537210 | 2022-06-19 |
Christine Luda Gordynskiy-ageyev is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1902537210. Registration indicates Christine Luda Gordynskiy-ageyev is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Christine Luda Gordynskiy-ageyev PAC |
| Practice Office Address | 3850 WOODHAVEN RD UNIT 1006 PHILADELPHIA, PA US |
| Practice Office Telephone | 2153904128 |
| Mailing Address | 3850 WOODHAVEN RD UNIT 1006 PHILADELPHIA, PA 191542762 US |
| Business Telephone | 2153904128 |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | MA063604
PA |