Provider Demographics
NPI:1184871766
Name:LANTIN, ANTONIO M (MD)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:M
Last Name:LANTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:7980 S CRESCENT BLVD
Mailing Address - Street 2:DELAWARE VALLEY MEDICAL
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-4106
Mailing Address - Country:US
Mailing Address - Phone:856-665-5100
Mailing Address - Fax:856-665-5212
Practice Address - Street 1:7980 S CRESCENT BLVD
Practice Address - Street 2:DELAWARE VALLEY MEDICAL
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-4106
Practice Address - Country:US
Practice Address - Phone:856-665-5100
Practice Address - Fax:856-665-5212
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03862900208D00000X
NJD06069300208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice