Provider Demographics
NPI:1912918095
Name:PIPITONE, ANTHONY J (DO)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:PIPITONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7453 LASCALA DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-1846
Mailing Address - Country:US
Mailing Address - Phone:330-650-2785
Mailing Address - Fax:
Practice Address - Street 1:15900 SNOW RD
Practice Address - Street 2:
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-2859
Practice Address - Country:US
Practice Address - Phone:216-925-0608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-002990207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0639894Medicaid
OH00000026967OtherANTHEM PROVIDER NUMBER
OH00000026967OtherANTHEM PROVIDER NUMBER
OH0542121Medicare PIN