Provider Demographics
NPI:1023017894
Name:IGNOCHECK, ANTHONY RAYMOND (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:RAYMOND
Last Name:IGNOCHECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16512-0369
Mailing Address - Country:US
Mailing Address - Phone:814-454-4530
Mailing Address - Fax:814-456-2375
Practice Address - Street 1:1202 STATE ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1914
Practice Address - Country:US
Practice Address - Phone:814-454-4530
Practice Address - Fax:814-456-2375
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036366E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00051110001OtherUNIVERA
PA183255OtherBLUE SHIELD
PA01982489OtherNY MEDICAL ASSISTANCE
PAP000398OtherGATEWAY
PA66426OtherUNISON
PA080094059OtherRR MEDICARE
PA518504OtherAETNA
PA0011703370002Medicaid
PA212566OtherUPMC
OH2472864OtherOH MEDICAL ASSISTANCE
PA183255E7CMedicare PIN
PA66426OtherUNISON