Provider Demographics
NPI:1629034905
Name:ABBRUZZI, ANTHONY JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:ABBRUZZI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 CHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-2525
Mailing Address - Country:US
Mailing Address - Phone:856-996-5600
Mailing Address - Fax:
Practice Address - Street 1:8025 BLACK HORSE PIKE STE 501
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-2967
Practice Address - Country:US
Practice Address - Phone:609-822-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH22443207RH0002X
NJ25MB09768400207R00000X
PAOS009203L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30067582OtherKEYSTONE MERCY
PA352310OtherHIGHMARK BLUE SHIELD
PA5332581OtherAETNA HMO
PA0016965000005Medicaid
PA0016965000001Medicaid
PA0643575000OtherKEYSTONE IBC
PA44086OS009203LOtherHEALTH PARTNERS
008677Medicare ID - Type Unspecified
PA352310OtherHIGHMARK BLUE SHIELD
PA0016965000005Medicaid