Provider Demographics
NPI:1801404926
Name:SALTSMAN, ANTHONY CHARLES (PA)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHARLES
Last Name:SALTSMAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 PINE ST
Mailing Address - Street 2:
Mailing Address - City:RENOVO
Mailing Address - State:PA
Mailing Address - Zip Code:17764-1629
Mailing Address - Country:US
Mailing Address - Phone:570-484-1741
Mailing Address - Fax:
Practice Address - Street 1:800 S LOGAN BLVD STE 1100
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-3051
Practice Address - Country:US
Practice Address - Phone:814-947-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA005282363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant