Provider Demographics
NPI:1346270204
Name:GATELARO, ANTHONY JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOHN
Last Name:GATELARO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 MONROE ST NW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-4139
Mailing Address - Country:US
Mailing Address - Phone:330-343-8668
Mailing Address - Fax:330-364-8826
Practice Address - Street 1:1251 MONROE ST NW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-4139
Practice Address - Country:US
Practice Address - Phone:330-343-8668
Practice Address - Fax:330-364-8826
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1835111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0957157Medicaid
OH000000134885OtherBLUE CROSS/ BLUE SHIELD
OH000000134885OtherBLUE CROSS/ BLUE SHIELD
OHU40480Medicare UPIN