Provider Demographics
NPI:1881843506
Name:AMY D'ANTONIO, M.D., LLC
Entity Type:Organization
Organization Name:AMY D'ANTONIO, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-375-0506
Mailing Address - Street 1:519 EAST DR
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-1609
Mailing Address - Country:US
Mailing Address - Phone:724-375-0506
Mailing Address - Fax:
Practice Address - Street 1:720 BLACKBURN RD
Practice Address - Street 2:SUITE C 301
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1459
Practice Address - Country:US
Practice Address - Phone:412-749-7127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429971208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty