Healthcare Provider Details

I. General information

NPI: 1760593370
Provider Name (Legal Business Name): ANTHONY J. DEMARCO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9525 FRANKFORD AVE
PHILADELPHIA PA
19114-2812
US

IV. Provider business mailing address

84 WOODHILL RD
NEWTOWN PA
18940-3012
US

V. Phone/Fax

Practice location:
  • Phone: 215-333-9696
  • Fax: 215-333-8514
Mailing address:
  • Phone: 267-226-0050
  • Fax: 215-504-8334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOS007111L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: