Provider Demographics
NPI:1831192582
Name:ORLANDO, ANTHONY (DPM)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:ORLANDO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6741 WOODHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-5217
Mailing Address - Country:US
Mailing Address - Phone:718-459-9575
Mailing Address - Fax:718-459-9548
Practice Address - Street 1:6741 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-5217
Practice Address - Country:US
Practice Address - Phone:718-459-9575
Practice Address - Fax:718-459-9548
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2023-10-06
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
NY4266213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4587370001Medicare NSC