Individual
DR. JOHN M. ANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 887-5775
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
139819-1
NY
2085R0202X
Diagnostic Radiology Physician
Primary
MD024966E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009161350001
—
PA
05
—
00785204
—
NY
01
—
300125078
RR MEDICARE PIN
PA
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039853
MEDICARE GROUP
PA
01
—
P00207601
RR MEDICARE PIN
NY
Enumeration date
02/03/2006
Last updated
03/25/2021
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