Provider Demographics
NPI:1124154307
Name:ALOSCO, ANTONIO (DPM)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:
Last Name:ALOSCO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:ANTHONY
Other - Middle Name:
Other - Last Name:ALOSCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:6814 BERGENLINE AVE
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-1826
Mailing Address - Country:US
Mailing Address - Phone:201-868-2333
Mailing Address - Fax:
Practice Address - Street 1:6814 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:NJ
Practice Address - Zip Code:07093-1826
Practice Address - Country:US
Practice Address - Phone:201-868-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00111000213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2009200Medicaid
NJAL455785Medicare PIN
NJ2009200Medicaid