Provider Demographics
NPI:1740209915
Name:TARTAMOSA, ANTHONY MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:TARTAMOSA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 OAKWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:RED LION
Mailing Address - State:PA
Mailing Address - Zip Code:17356-9093
Mailing Address - Country:US
Mailing Address - Phone:717-848-5550
Mailing Address - Fax:717-848-5551
Practice Address - Street 1:20 NORTH HARRISON STREET
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402
Practice Address - Country:US
Practice Address - Phone:717-848-5550
Practice Address - Fax:717-848-5551
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC6507L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02166102OtherBLUE CROSS
PA02166102OtherBLUE CROSS
U61476Medicare UPIN