Healthcare Provider Details

I. General information

NPI: 1548214695
Provider Name (Legal Business Name): FRANK WILLIAM MARCANTONIO PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 HEATHERWOOD DR
EAST NORRITON PA
19403-4427
US

IV. Provider business mailing address

PO BOX 8500-6335
PHILADELPHIA PA
19178-0001
US

V. Phone/Fax

Practice location:
  • Phone: 215-873-3279
  • Fax:
Mailing address:
  • Phone: 215-612-4000
  • Fax: 215-807-8235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberC50000449
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA052298
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberC0009790
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA052298
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number25MP00160000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: