Provider Demographics
NPI:1407046824
Name:CAMMARATA, ANTONINO SIMONE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTONINO
Middle Name:SIMONE
Last Name:CAMMARATA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6120 W BELL RD
Mailing Address - Street 2:STE 130
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3782
Mailing Address - Country:US
Mailing Address - Phone:623-512-4326
Mailing Address - Fax:623-594-2252
Practice Address - Street 1:6120 W BELL RD
Practice Address - Street 2:STE 130
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3782
Practice Address - Country:US
Practice Address - Phone:623-512-4326
Practice Address - Fax:623-594-2252
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2016-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ005651208600000X
PAOS014837208600000X
NJ25MB08495000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery