Provider Demographics
NPI:1215097100
Name:ANTHONY C CANTERNA MD LLC
Entity type:Organization
Organization Name:ANTHONY C CANTERNA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CANTERNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-228-4658
Mailing Address - Street 1:940 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301
Mailing Address - Country:US
Mailing Address - Phone:724-228-4658
Mailing Address - Fax:724-228-9151
Practice Address - Street 1:195 W BEAU ST
Practice Address - Street 2:JEFFERSON COURT PLAZA
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4401
Practice Address - Country:US
Practice Address - Phone:724-222-5940
Practice Address - Fax:724-222-8940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014882410001Medicaid
PA00154861OtherBS
B40727Medicare UPIN
PA176650VIZMedicare ID - Type Unspecified