Individual
DR. ANTHONY ANTONELLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1098 W BALTIMORE PIKE, SUITE 3302, MEDIA, PA 19063-5139
(610) 565-6780
(610) 565-9390
Mailing address
1098 W BALTIMORE PIKE, SUITE 3302, MEDIA, PA 19063-5139
(610) 565-6780
(610) 565-9390
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD-044041-E
PA
207W00000X
Ophthalmology Physician
Primary
MD044041E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001174031
—
PA
Enumeration date
06/17/2005
Last updated
11/29/2023
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