Provider Demographics
NPI:1508837162
Name:ANTHONY J SARACENI, DO PC
Entity Type:Organization
Organization Name:ANTHONY J SARACENI, DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SARACENI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-462-2783
Mailing Address - Street 1:25 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:PA
Mailing Address - Zip Code:17976-1778
Mailing Address - Country:US
Mailing Address - Phone:570-462-2783
Mailing Address - Fax:570-462-2783
Practice Address - Street 1:25 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:PA
Practice Address - Zip Code:17976-1778
Practice Address - Country:US
Practice Address - Phone:570-462-2783
Practice Address - Fax:570-462-2783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DG3559OtherRAILROAD MEDICARE
PA1384758OtherHIGHMARK BLUE SHIELD
PA50000240OtherCAPITAL BLUE CROSS
PA115417Medicare PIN