| Doctor Name: | ANTHONY COLAVITA |
| NPI Number: | 1457472300 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD0330026 |
| Business Practice Address: | 6334 Elmwood Ave Phila, PA - 19142 |
| Business Phone Number: | 2157267066 |
| Business Fax Number: | 2157245911 |
| Mailing Address: | 411 Williamson Rd, GLADWYNE |
| State: | PA |
| Postal Code: | 19035 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/02/2007 |
| NPI Last Update Date: | 07/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD0330026 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |