MEDICARE: ALEX EDWARD PINTO

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	363AS0400X	Surgical Physician Assistant	25MP00584900	NJ

General Provider Information

NPI Number	:	1922647627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX EDWARD PINTO

Provider Business Mailing Address
First Line	:	4170 CITY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-1610
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BETHANY RD STE 21
Second Line	:
City	:	HAZLET
State	:	NJ
Zip	:	07730-1660
Country	:	US
Telephone Number	:	732-264-8282
Fax Number	:	732-497-9782

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

Provider Enumeration Date	:	12/27/2019
Last Update Date	:	05/18/2021

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Directions to “ ALEX EDWARD PINTO ” Practice Location

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