Provider Demographics
NPI:1821096884
Name:SANZONE, ANTHONY JOSEPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:SANZONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 E MAIN ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-5036
Mailing Address - Country:US
Mailing Address - Phone:607-785-3388
Mailing Address - Fax:607-785-4072
Practice Address - Street 1:609 E MAIN ST
Practice Address - Street 2:SUITE 10
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-5036
Practice Address - Country:US
Practice Address - Phone:607-785-3388
Practice Address - Fax:607-785-4072
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004135-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY161356692OtherBLUE CROSS BLUE SHIELD
NY10034355OtherCDPHP
NY01007047Medicaid
NY4556107OtherAETNA
NY540007OtherMVP
NY0049122OtherGHI
NY517060Medicare PIN
NY10034355OtherCDPHP
NY51706BMedicare ID - Type Unspecified
GA480007742Medicare NSC