Provider Demographics
NPI:1588797443
Name:CONTINO, PHILIP ANTHONY JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:ANTHONY
Last Name:CONTINO
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1205
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28744-1205
Mailing Address - Country:US
Mailing Address - Phone:828-369-4257
Mailing Address - Fax:828-349-6603
Practice Address - Street 1:190 RIVERVIEW ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2612
Practice Address - Country:US
Practice Address - Phone:828-369-4257
Practice Address - Fax:828-349-6603
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100249174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8933654Medicaid
NC2744582Medicare ID - Type Unspecified
NCS46457Medicare UPIN