Provider Demographics
NPI:1083761803
Name:PORTO, ANTHONY F (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:F
Last Name:PORTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PARK ST
Mailing Address - Street 2:APT. 156
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06504-8901
Mailing Address - Country:US
Mailing Address - Phone:718-741-2150
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:MMC - PEDIATRIC EMERGENCY MED
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-741-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2269052080P0204X
CT0452842080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine