Anthony J Cincotta, DO
Individual provider Active NPI Family Medicine Physician · Newtown Square, PA
NPI 1730145293 · NPPES record last updated Jun 28, 2012
Key facts
- NPI
- 1730145293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 05002053L (PA)
- Practice address
- 3475 West Chester PK
Ste 200
Newtown Square, PA 19073 - Phone
- (610) 356-0300
- Fax
- (610) 356-1981
- NPI assigned
- Apr 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05002053L | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suburban Primary Care | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 05002053L | PA | Yes |
Addresses
Primary practice location
3475 West Chester PK
Ste 200
Newtown Square, PA 19073
Mailing address
3475 West Chester PK
Ste 200
Newtown Square, PA 19073
Phone (610) 356-0300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01634385 | Medicaid | PA |
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All providers in Newtown Square, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.