Basic Information
| Provider Information | |||||||||
| NPI: | 1679513444 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANTONESCU | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2655 ELLWOOD RD | ||||||||
| Address2: | |||||||||
| City: | NEW CASTLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161016217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246542776 | ||||||||
| FaxNumber: | 7246573203 | ||||||||
| Practice Location | |||||||||
| Address1: | 2655 ELLWOOD RD | ||||||||
| Address2: | |||||||||
| City: | NEW CASTLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161016217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246542776 | ||||||||
| FaxNumber: | 7246573203 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 04/12/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD055686L | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.