Provider Demographics
NPI:1073910923
Name:ABDELMASEEH, TONY (MD)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:ABDELMASEEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:TANAGHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:JERMYN
Mailing Address - State:PA
Mailing Address - Zip Code:18433-1121
Mailing Address - Country:US
Mailing Address - Phone:570-230-0019
Mailing Address - Fax:570-230-0013
Practice Address - Street 1:5 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:JERMYN
Practice Address - State:PA
Practice Address - Zip Code:18433-1121
Practice Address - Country:US
Practice Address - Phone:570-230-0019
Practice Address - Fax:570-230-0013
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD461253208000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatrics