Healthcare Provider Details

I. General information

NPI: 1528050168
Provider Name (Legal Business Name): ANTHONY FREDERICK UBERTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3438 STATE ROUTE 208
NEW WILMINGTON PA
16142-1012
US

IV. Provider business mailing address

3438 STATE ROUTE 208
NEW WILMINGTON PA
16142-1012
US

V. Phone/Fax

Practice location:
  • Phone: 724-946-8979
  • Fax: 724-946-2938
Mailing address:
  • Phone: 724-946-8979
  • Fax: 724-946-2938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD050872L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: