Provider Demographics
NPI:1538925847
Name:FATEBENE, ANTHONY JOHN
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JOHN
Last Name:FATEBENE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 MEADOW VIEW LN
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-1450
Mailing Address - Country:US
Mailing Address - Phone:412-629-2017
Mailing Address - Fax:
Practice Address - Street 1:222 W EDISON AVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-2174
Practice Address - Country:US
Practice Address - Phone:724-652-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant