Individual
ANTONIO PANEBIANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2560 MILL CREEK RD, MACUNGIE, PA 18062-8824
(484) 221-3717
(610) 351-1158
Mailing address
2560 MILL CREEK RD, MACUNGIE, PA 18062-8824
(484) 221-3717
(610) 351-1158
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD028954L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006407420003
—
PA
05
—
0006407420004
—
PA
01
—
0040153000
INDEPENDENCE BLUE CROSS
PA
01
—
017216
HIGHMARK PIN
PA
01
—
50026859
CAPITAL BLUE CROSS
PA
Enumeration date
08/23/2005
Last updated
02/28/2013
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