MEDICARE: ANTONIO PANEBIANCO 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
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	MD028954L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0040153000	OTHER	PA	INDEPENDENCE BLUE CROSS
2	017216	OTHER	PA	HIGHMARK PIN
3	50026859	OTHER	PA	CAPITAL BLUE CROSS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447243787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONIO PANEBIANCO MD

Provider Business Mailing Address
First Line	:	2560 MILL CREEK RD
Second Line	:
City	:	MACUNGIE
State	:	PA
Zip	:	18062-8824
Country	:	US
Telephone Number	:	484-221-3717
Fax Number	:	610-351-1158

Provider Business Practice Location Address
First Line	:	2560 MILL CREEK RD
Second Line	:
City	:	MACUNGIE
State	:	PA
Zip	:	18062-8824
Country	:	US
Telephone Number	:	484-221-3717
Fax Number	:	610-351-1158

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	02/28/2013

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Directions to “ ANTONIO PANEBIANCO MD” Practice Location

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