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General NPI Number Information
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NPI Number | 1558538074
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Entity Type | Individual
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Provider Name | ANTHONY MICHAEL LETIZIO II D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 583 SHOEMAKER ROAD
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-4201
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Country | US
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Telephone | 484-378-2424
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Fax | 484-723-5324
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Provider Business Mailing Address
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Address Line | 857 MONTGOMERY AVE FL 2
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City | PENN VALLEY
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State | PA
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Zip | 19072-1541
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Country | US
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Telephone | 610-664-2951
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Fax | 610-664-2131
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | OS014724
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS014724
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License Number State | PA
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