Provider Demographics
NPI:1316913015
Name:PISCIOTTA, ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:PISCIOTTA
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MOUNT KEMBLE AVE
Mailing Address - Street 2:THEBAUD BUILDING, FOURTH FLOOR
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5155
Mailing Address - Country:US
Mailing Address - Phone:973-267-2293
Mailing Address - Fax:973-267-3144
Practice Address - Street 1:95 MOUNT KEMBLE AVE
Practice Address - Street 2:THEBAUD BUILDING, FOURTH FLOOR
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5155
Practice Address - Country:US
Practice Address - Phone:973-267-2293
Practice Address - Fax:973-267-3144
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05580500208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4566009Medicaid
NJ4566009Medicaid
NJA61299Medicare UPIN