Healthcare Provider Details
I. General information
NPI: 1023091816
Provider Name (Legal Business Name): ANTHONY J GERAMITA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/25/2005
Last Update Date: 08/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1112 S MILL ST
NEW CASTLE PA
16101-4629
US
IV. Provider business mailing address
100 SHENANGO AVE
SHARON PA
16146-1503
US
V. Phone/Fax
- Phone: 724-658-4564
- Fax: 724-657-8563
- Phone: 724-704-7386
- Fax: 724-704-7390
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC007191L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: