Healthcare Provider Details

I. General information

NPI: 1689789752
Provider Name (Legal Business Name): JAMES A PANTANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 S CEDAR CREST BLVD SUITE 500
ALLENTOWN PA
18103-6202
US

IV. Provider business mailing address

1202 S CEDAR CREST BLVD SUITE 500
ALLENTOWN PA
18103-6202
US

V. Phone/Fax

Practice location:
  • Phone: 610-770-2200
  • Fax: 610-776-6645
Mailing address:
  • Phone: 610-770-2200
  • Fax: 610-776-6645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD016312E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: