Provider Demographics
NPI:1881671253
Name:PICCOLO, ANTHONY RALPH (DO)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:RALPH
Last Name:PICCOLO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-1250
Mailing Address - Country:US
Mailing Address - Phone:717-846-2168
Mailing Address - Fax:717-699-1300
Practice Address - Street 1:1225 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-1250
Practice Address - Country:US
Practice Address - Phone:717-846-2168
Practice Address - Fax:717-699-1300
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003760L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA009629420003Medicaid
PAC31034Medicare UPIN
PA009629420003Medicaid