Provider Demographics
NPI:1093329872
Name:D'ORSANEO, PETER ANTHONY (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:ANTHONY
Last Name:D'ORSANEO
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 PROVIDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-5218
Mailing Address - Country:US
Mailing Address - Phone:610-583-1177
Mailing Address - Fax:
Practice Address - Street 1:2201 PROVIDENCE AVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-5218
Practice Address - Country:US
Practice Address - Phone:610-583-1177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2024-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025706363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology