Provider Demographics
NPI:1649308974
Name:SILVETTI, ANTHONY JOSEPH (OD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:SILVETTI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-2036
Mailing Address - Country:US
Mailing Address - Phone:610-759-4688
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 209 WEST END PLAZA
Practice Address - Street 2:BOX 65
Practice Address - City:GILBERT
Practice Address - State:PA
Practice Address - Zip Code:18331
Practice Address - Country:US
Practice Address - Phone:610-681-6116
Practice Address - Fax:610-681-6128
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE007077T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASI595679OtherBLUE SHIELD
PAPA8528OtherEYEMED
PA595679Medicare ID - Type Unspecified
PAU22757Medicare UPIN