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NPI Code Detail

MEDICARE: DR. MATTHEW ANTHONY SACCO MD

MEDICARE: DR. MATTHEW ANTHONY SACCO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianMD028724EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101782101OTHERBC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3406694OTHERBS

General Provider Information

NPI Number : 1275533291
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW ANTHONY SACCO MD
Provider Business Mailing Address
First Line : 420 S JACKSON ST
Second Line :
City : POTTSVILLE
State : PA
Zip : 17901-3625
Country : US
Telephone Number : 570-621-5325
Fax Number : 570-621-5325
Provider Business Practice Location Address
First Line : 420 S JACKSON ST
Second Line :
City : POTTSVILLE
State : PA
Zip : 17901-3625
Country : US
Telephone Number : 570-621-5325
Fax Number : 570-621-5325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2005
Last Update Date : 07/16/2014

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