Provider Demographics
NPI:1154386068
Name:CANTAGALLO, VAL RAYMOND (MD)
Entity type:Individual
Prefix:
First Name:VAL
Middle Name:RAYMOND
Last Name:CANTAGALLO
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 1:2373 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020
Mailing Address - Country:US
Mailing Address - Phone:215-752-1810
Mailing Address - Fax:215-752-1060
Practice Address - Street 1:2373 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020
Practice Address - Country:US
Practice Address - Phone:215-752-1810
Practice Address - Fax:215-752-1060
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020564E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30033137OtherKMHP
PA203261266OtherCOVENTRY
PA37088MD020564EOtherHEALTHPARTNERS
PA026948OtherPA BS PROVIDER#
PA203261266OtherUNITEDHEALTHCARE
PA62176278OtherMULTIPLAN
PA6794809OtherCIGNA
PA0058321000OtherKHPE PROVIDER#
PA1007545120003Medicaid
PA4306878OtherAETNA USHC PPO
PA0058321000OtherIBC
PA1256068OtherAETNA USHC HMO
PA4306878OtherAETNA USHC PPO
PA37088MD020564EOtherHEALTHPARTNERS
PAB33584Medicare UPIN