MEDICARE: DR. DEBORAH ANN GENTILE 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	207K00000X	Allergy & Immunology Physician	MD060203L	PA
2	2080P0201X	Pediatric Allergy/Immunology Physician	MD060203L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	830918	OTHER	PA	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619979333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH ANN GENTILE MD

Provider Business Mailing Address
First Line	:	200 RENAISSANCE DR STE 105
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16001-7612
Country	:	US
Telephone Number	:	724-256-8514
Fax Number	:	724-256-9049

Provider Business Practice Location Address
First Line	:	200 RENAISSANCE DR STE 105
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16001-7612
Country	:	US
Telephone Number	:	724-256-8514
Fax Number	:	724-256-9049

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	01/14/2026

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Directions to “ DR. DEBORAH ANN GENTILE MD” Practice Location

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