Provider Demographics
NPI:1821173170
Name:SINESE, ANITA JANE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:JANE
Last Name:SINESE
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:207 N BROAD ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1500
Mailing Address - Country:US
Mailing Address - Phone:267-479-4142
Mailing Address - Fax:215-463-3820
Practice Address - Street 1:125 MEDICAL CAMPUS DR STE 101
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446
Practice Address - Country:US
Practice Address - Phone:215-361-5020
Practice Address - Fax:215-362-1195
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2018-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS011830207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001961260Medicaid
PAH75727Medicare UPIN
PA001961260Medicaid