Individual
RONNY E ANTELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 NORTH OXFORD VALLEY ROAD, SUITE 503, FAIRLESS HILLS, PA 19030
(215) 949-7925
(215) 943-1304
Mailing address
333 NORTH OXFORD VALLEY ROAD, SUITE 503, FAIRLESS HILLS, PA 19030
(215) 949-7925
(215) 943-1304
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD066714L
PA
2084N0400X
Neurology Physician
Primary
MD066714L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017943500002
—
PA
01
—
0293984000
INDEPENDENCE BLUE CROSS
PA
01
—
1113859
KEYSTONE MERCY
PA
01
—
111885
HIGHMARK BLUE SHIELD
PA
01
—
130021904
RAILROAD MEDICARE
PA
01
—
2257495
AETNA
PA
01
—
29404
HEALTH PARTNERS
PA
01
—
2Y2767
ELDER HEALTH
PA
Enumeration date
07/02/2006
Last updated
03/01/2016
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