Provider Demographics
NPI:1902965999
Name:PANTUSO, ANNAMARIE (RAC,DOM)
Entity Type:Individual
Prefix:
First Name:ANNAMARIE
Middle Name:
Last Name:PANTUSO
Suffix:
Gender:F
Credentials:RAC,DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:954 TOWN CTR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-5182
Mailing Address - Country:US
Mailing Address - Phone:215-348-7393
Mailing Address - Fax:215-348-7394
Practice Address - Street 1:954 TOWN CTR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-5182
Practice Address - Country:US
Practice Address - Phone:215-348-7393
Practice Address - Fax:215-348-7394
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM587171100000X
PAOM000010171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist