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General NPI Number Information
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NPI Number | 1730101858
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Entity Type | Individual
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Provider Name | ATHOS R CERRATO DO
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 1120 W TOWNSHIP LINE RD FL 2
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City | HAVERTOWN
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State | PA
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Zip | 19083-4930
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Country | US
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Telephone | 877-286-5115
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Fax | 866-286-4935
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Provider Business Mailing Address
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Address Line | 2207 CONCORD PIKE STE 290
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City | WILMINGTON
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State | DE
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Zip | 19803-2908
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Country | US
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Telephone | 856-981-4220
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Fax |
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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 | 207LA0401X
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Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
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License Number | OS-005690L
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License Number State | PA
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