Individual
DR. ANTONIO FUNCHES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7131 FRANKFORD AVE STE 39, PHILADELPHIA, PA 19135-1008
(215) 332-4164
(215) 332-9638
Mailing address
101 E OLNEY AVE STE 400, PHILADELPHIA, PA 19120-2470
(215) 456-1825
(215) 456-1825
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA10155100
NJ
207Q00000X
Family Medicine Physician
Primary
MD455675
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103046777
—
PA
Enumeration date
05/09/2012
Last updated
05/12/2023
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