Basic Information
| Provider Information | |||||||||
| NPI: | 1144222555 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMOROSO | ||||||||
| FirstName: | ANTHONY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 783311 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191783311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848844500 | ||||||||
| FaxNumber: | 4848840699 | ||||||||
| Practice Location | |||||||||
| Address1: | 3735 NAZARETH RD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | EASTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180458338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108292200 | ||||||||
| FaxNumber: | 6108292211 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2005 | ||||||||
| LastUpdateDate: | 03/02/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD036690E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 137494 | 01 | PA | HIGHMARK BS | OTHER | 0011404090002 | 05 | PA | MEDICAID |