MEDICARE: DR. ANTHONY F PERNA M.D.

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	207R00000X	Internal Medicine Physician	148393	NY

General Provider Information

NPI Number	:	1568429330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY F PERNA M.D.

Provider Business Mailing Address
First Line	:	1430 COLVIN BLVD
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14223-1440
Country	:	US
Telephone Number	:	716-874-4060
Fax Number	:	716-871-1198

Provider Business Practice Location Address
First Line	:	1430 COLVIN BLVD
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14223-1440
Country	:	US
Telephone Number	:	716-874-4060
Fax Number	:	716-871-1198

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	10/13/2014

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