Provider Demographics
NPI:1255324364
Name:LA FORGIA, ANTHONY P (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:P
Last Name:LA FORGIA
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 1:108 ALDEN ST
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2131
Mailing Address - Country:US
Mailing Address - Phone:908-497-3975
Mailing Address - Fax:
Practice Address - Street 1:108 ALDEN ST
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2131
Practice Address - Country:US
Practice Address - Phone:908-497-3975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA066020002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0054097Medicaid
NJ087339RW8Medicare PIN
NJ087339Medicare ID - Type Unspecified
NJ0054097Medicaid