Provider Demographics
NPI:1700812666
Name:CARRATO, ANTHONY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:CARRATO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:50 MOISEY DR STE 214
Practice Address - Street 2:
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-9297
Practice Address - Country:US
Practice Address - Phone:570-501-6900
Practice Address - Fax:570-501-6945
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050176L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015907990006Medicaid
PA0015907990007Medicaid
PA0015907990006Medicaid