Provider Demographics
NPI:1942316658
Name:MANGIARACINA, ANTHONY III (DO)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:MANGIARACINA
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 EAGLEVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1157
Mailing Address - Country:US
Mailing Address - Phone:610-561-6400
Mailing Address - Fax:
Practice Address - Street 1:278 EAGLEVIEW BLVD
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1157
Practice Address - Country:US
Practice Address - Phone:610-561-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004865L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00946116-05OtherAMERICHOICE-FF
PA20045151OtherAMERIHEALTH MERCY
PA049648OtherHIGHMARK BLUE SHIELD
PA1978446OtherFIRST HEALTH
PA1096736OtherKEYSTONE MERCY
PA810314246OtherPHCS
PA930073142OtherRAILROAD MEDICARE
PA0009461160005Medicaid
PA0009461160006Medicaid
PA00946116-03OtherAMERICHOICE TC
PA049648OtherPERSONAL CHOICE
PA07645OtherHEALTH PARTNERS
PA6513766OtherCIGNA
PA00946116-04OtherAMERICHOICE-FB
PA452729OtherAETNA CONTRACT
PA0009461160004Medicaid
PA0023427000OtherKEYSTONE, IBC
PA1978446OtherFIRST HEALTH
PA049648Medicare ID - Type Unspecified