Antonio, Mark

Antonio, Mark is an individual health care provider with primary practice located at 746 Jefferson Ave , Scranton PA 18510-1624. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Antonio, Mark can be contacted via phone (570) 346-7797.

Contact Information

Primary practice address
746 Jefferson Ave Scranton PA 18510-1624
Phone: (570) 346-7797
Fax: (570) 342-9802
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 39894 Pennsylvania

Profile Details

NPI number 1093798886
LBN Legal business name Antonio, Mark
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 25th, 2005
Last updated Apr 6th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093798886 NPPES
Pennsylvania Other 430014717 RR MEDICARE
Pennsylvania Other 011551VKC RR MEDICARE

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