Provider Demographics
NPI:1417957770
Name:ZERBONIA, ANGELO NICHOLAS (DO)
Entity Type:Individual
Prefix:
First Name:ANGELO
Middle Name:NICHOLAS
Last Name:ZERBONIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:201 STATE STREET
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16550-0002
Mailing Address - Country:US
Mailing Address - Phone:814-877-6182
Mailing Address - Fax:814-877-6149
Practice Address - Street 1:201 STATE STREET
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0002
Practice Address - Country:US
Practice Address - Phone:814-877-6182
Practice Address - Fax:814-877-6149
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005471L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01599788OtherNY MEDICAID
WV1068821OtherWEST VIRGINIA WORK COMP
PA300137964OtherRR MEDICARE
PA147539OtherUNISON - IMAGING CENTER
PA3183653OtherAETNA
PA308135OtherUPMC
PA0011217800008Medicaid
OH2383504OtherOH MEDICAID
NY00026037102OtherUNIVERA
PA139773OtherUNISON - HAMOT RADIOLOGY
PA1514536OtherGATEWAY
PA472491OtherBLUE SHIELD
WV1068821OtherWEST VIRGINIA WORK COMP
PA1514536OtherGATEWAY