NPI 1629441696 · live from the CMS NPI Registry
Nicholas Anzideo, PA
Physician Assistant in North Wales, PA. National Provider Identifier 1629441696, active.
NPI record
| NPI | 1629441696 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 1010 Horsham Rd Ste 201, North Wales, PA 19454 |
| Practice phone | 215-362-2385 |
| Mailing address | 657 Whittier Dr, Warminster, PA 18974 |
| Enumerated | November 12, 2015 |
| Last updated | April 14, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical | 363AM0700X | 25MP00518300 (NJ) |
| Physician Assistant, Medical | 363AM0700X | MA058011 (PA) |
| Physician Assistant, Medical | 363AM0700X | OA003706 (PA) |
| Physician Assistant primary | 363A00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.