Provider Demographics
NPI:1518224575
Name:ANTHONY M. CARRATO, M.D., PC
Entity Type:Organization
Organization Name:ANTHONY M. CARRATO, M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARRATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-450-6440
Mailing Address - Street 1:943 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-1800
Mailing Address - Country:US
Mailing Address - Phone:570-450-6440
Mailing Address - Fax:570-450-6442
Practice Address - Street 1:943 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-1800
Practice Address - Country:US
Practice Address - Phone:570-450-6440
Practice Address - Fax:570-450-6442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015907990006Medicaid
PA0015907990006Medicaid