Provider Demographics
NPI:1659431195
Name:PASTENA, ANTHONY M (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:M
Last Name:PASTENA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:438 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-5066
Mailing Address - Country:US
Mailing Address - Phone:973-542-0384
Mailing Address - Fax:973-542-1172
Practice Address - Street 1:249 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2710
Practice Address - Country:US
Practice Address - Phone:973-542-1106
Practice Address - Fax:973-542-1172
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB63103207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ000921Medicare PIN
NJG57955Medicare UPIN