Healthcare Provider Details

I. General information

NPI: 1508836149
Provider Name (Legal Business Name): PETER F ROVITO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 05/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

842 N 19TH ST
ALLENTOWN PA
18104-4039
US

IV. Provider business mailing address

842 N 19TH ST
ALLENTOWN PA
18104-4039
US

V. Phone/Fax

Practice location:
  • Phone: 610-437-6119
  • Fax: 610-437-4280
Mailing address:
  • Phone: 610-437-6119
  • Fax: 610-437-4280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD033023E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: