Provider Demographics
NPI:1396754545
Name:CAMASTO, ANGELA MARIE (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:CAMASTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:3800 SIERRA CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8476
Practice Address - Country:US
Practice Address - Phone:484-664-2090
Practice Address - Fax:484-664-2089
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2016-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD070857L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH18946Medicare UPIN