Provider Demographics
NPI:1215781273
Name:AMATO, ANITA (LMT, CMTPT)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:AMATO
Suffix:
Gender:F
Credentials:LMT, CMTPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 PENHURST DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5321
Mailing Address - Country:US
Mailing Address - Phone:412-414-5330
Mailing Address - Fax:412-900-2425
Practice Address - Street 1:3824 NORTHERN PIKE STE 495
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2162
Practice Address - Country:US
Practice Address - Phone:412-414-5330
Practice Address - Fax:412-900-2425
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG007153225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist