Organization
COMPREHENSIVE PAIN CARE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY J COLANTONIO MD (OWNER)
(814) 333-5736
Entity
Organization
Contact information
Practice address
1034 GROVE ST, MEADVILLE, PA 16335-2945
(814) 333-5736
(814) 333-5819
Mailing address
1034 GROVE STREET, MEADVILLE, PA 16335-2945
(814) 333-5736
(814) 333-5832
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD421359
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019660890002
—
PA
05
—
0019660980002
—
PA
01
—
1483443
HIGHMARK BLUE SHIELD
PA
01
—
320575
UPMC HEALTH PLAN
PA
01
—
DA2462
RAILROAD MEDICARE
PA
Enumeration date
06/20/2006
Last updated
10/07/2011
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