Provider Demographics
NPI:1205386430
Name:RAINERI, ANTHONY RAYMOND (PA-C)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:RAYMOND
Last Name:RAINERI
Suffix:
Gender:
Credentials:PA-C
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Mailing Address - Street 1:150 MUNDY STREET
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6830
Mailing Address - Country:US
Mailing Address - Phone:570-829-0031
Mailing Address - Fax:570-802-0104
Practice Address - Street 1:150 MUNDY STREET
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6830
Practice Address - Country:US
Practice Address - Phone:570-829-0031
Practice Address - Fax:570-802-0104
Is Sole Proprietor?:No
Enumeration Date:2016-10-12
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA058585363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant