Healthcare Provider Details

I. General information

NPI: 1972508794
Provider Name (Legal Business Name): ANTHONY BARON COLANGELO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date: 03/20/2006
Reactivation Date: 03/24/2006

III. Provider practice location address

510 PARK AVE
ELLWOOD CITY PA
16117-2025
US

IV. Provider business mailing address

510 PARK AVE
ELLWOOD CITY PA
16117-2025
US

V. Phone/Fax

Practice location:
  • Phone: 724-758-4537
  • Fax: 724-758-7344
Mailing address:
  • Phone: 724-758-4537
  • Fax: 724-758-7344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number022953E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number022953E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: