1174963227 NPI number — DR. ANTHONY JOSEPH PIRAINO M.D., PH.D.

Table of content: DR. ANTHONY JOSEPH PIRAINO M.D., PH.D. (NPI 1174963227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174963227 NPI number — DR. ANTHONY JOSEPH PIRAINO M.D., PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIRAINO
Provider First Name:
ANTHONY
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174963227
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
172 DAM VIEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEDIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19063-1832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-891-1860
Provider Business Mailing Address Fax Number:
844-835-4785

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 CONCORD PIKE
Provider Second Line Business Practice Location Address:
MAIL STOP B2B-023
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19897-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-885-8456
Provider Business Practice Location Address Fax Number:
302-885-8456
Provider Enumeration Date:
07/02/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  MD034163E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208U00000X , with the licence number: MD034163E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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