Individual
DR. JEFFREY A RANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 MEADE ST STE U3, WELLSBORO, PA 16901
(570) 724-3636
(570) 724-3326
Mailing address
2600 MAIN ST, STE 119, BRIDGEPORT, CT 06606-5305
(570) 724-3636
(570) 724-3326
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
025617
CT
208800000X
Urology Physician
Primary
MD464517
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001256171
—
CT
01
—
010025617CT01
BC/BS
—
01
—
020035
HEALTHNET
—
01
—
025617
CONNETICARE
—
01
—
340004055
RAILROAD MEDICARE
—
01
—
567460
AETNA
—
01
—
ZS719
OXFORD
—
Enumeration date
06/09/2005
Last updated
04/29/2020
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