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NPI Code Detail

MEDICARE: DR. ANGELA M. DEANTONIO M.D.

MEDICARE: DR. ANGELA M. DEANTONIO 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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianMD034610EPA
2207RP1001XPulmonary Disease PhysicianMD034610EPA

General Provider Information

NPI Number : 1568438794
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA M. DEANTONIO M.D.
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-3034
Country : US
Telephone Number : 570-271-6144
Fax Number : 570-271-6578
Provider Business Practice Location Address
First Line : 1000 E MOUNTAIN BLVD
Second Line :
City : WILKES BARRE
State : PA
Zip : 18711-0027
Country : US
Telephone Number : 570-820-6114
Fax Number : 570-826-7698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 09/11/2025

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