1194002691 NPI number — MR. ANTHONY FRANCIS FORTE M.S.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194002691 NPI number — MR. ANTHONY FRANCIS FORTE M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FORTE
Provider First Name:
ANTHONY
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FORTE
Provider Other First Name:
ANTHONY
Provider Other Middle Name:
FRANCIS
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1194002691
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4266 SALMON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19137-1519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-831-4600
Provider Business Mailing Address Fax Number:
215-831-7917

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4266 SALMON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19137-1519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-831-6958
Provider Business Practice Location Address Fax Number:
215-831-7917
Provider Enumeration Date:
11/11/2011

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: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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