Provider Demographics
NPI:1679519482
Name:ANTHONY COLANGELO, M.D., P.C.
Entity type:Organization
Organization Name:ANTHONY COLANGELO, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:B
Authorized Official - Last Name:COLANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-758-4537
Mailing Address - Street 1:510 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117-2025
Mailing Address - Country:US
Mailing Address - Phone:724-758-4537
Mailing Address - Fax:724-758-7344
Practice Address - Street 1:510 PARK AVE
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117-2025
Practice Address - Country:US
Practice Address - Phone:724-758-4537
Practice Address - Fax:724-758-7344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA022953E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014678780001Medicaid
PA1622543OtherHIGHMARK
PA1622543OtherHIGHMARK