Provider Demographics
NPI:1124071857
Name:ANZALONE, ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:ANZALONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 DIETZ ST
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3223
Mailing Address - Country:US
Mailing Address - Phone:973-778-7334
Mailing Address - Fax:866-830-7291
Practice Address - Street 1:1272 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1344
Practice Address - Country:US
Practice Address - Phone:973-778-7334
Practice Address - Fax:866-830-7291
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO42475207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ444480Medicare ID - Type Unspecified
NJB16479Medicare UPIN