Individual
JOHN MICHAEL PENTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 S 7TH AVE, SUITE 305, WEST READING, PA 19611-1410
(610) 376-6990
(610) 376-6458
Mailing address
301 S 7TH AVE, SUITE 305, WEST READING, PA 19611-1410
(610) 376-6990
(610) 376-6458
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD012179E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006080480001
—
PA
01
—
0019754000
INDEPENDENCE BLUE CROSS
—
01
—
01161501
CAPITAL BLUE CROSS
—
01
—
076111
HIGHMARK BLUE SHIELD
—
01
—
1505952
GATEWAY
—
01
—
174356
MEDPLUS
—
01
—
20008539
AMERIHEALTH MERCY
—
01
—
88761
AETNA
—
01
—
P00309195
RAILROAD MEDICARE
—
Enumeration date
07/12/2005
Last updated
11/07/2007
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