Individual
PATRICK ANTONIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 MANTUA PIKE, WOODBURY, NJ 08096-3233
(856) 812-2220
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0116025196
VA
207Q00000X
Family Medicine Physician
H0080401
MD
207R00000X
Internal Medicine Physician
Primary
25MB10216800
NJ
Other
Enumeration date
07/02/2012
Last updated
03/26/2018
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