Provider Demographics
NPI:1093329872
Name:D'ORSANEO, PETER ANTHONY (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ANTHONY
Last Name:D'ORSANEO
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WALNUT ST.
Mailing Address - Street 2:17TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:215-829-3523
Mailing Address - Fax:215-829-6023
Practice Address - Street 1:800 WALNUT ST.
Practice Address - Street 2:17TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:215-829-3523
Practice Address - Fax:215-829-6023
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025706363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology