Provider Demographics
NPI:1467026682
Name:ONETTO, ANDRES J
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:J
Last Name:ONETTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONEMAUGH MEMORIAL MEDICAL CENTER
Mailing Address - Street 2:1086 FRANKLIN STREET
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905
Mailing Address - Country:US
Mailing Address - Phone:814-534-3745
Mailing Address - Fax:
Practice Address - Street 1:CONEMAUGH MEMORIAL MEDICAL CENTER
Practice Address - Street 2:1086 FRANKLIN STREET
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905
Practice Address - Country:US
Practice Address - Phone:814-534-3745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMT227020207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program