IndividualActive
Brian Antonucci, PA-C
NPI 1700167616 · Surgical Physician Assistant · Baltimore, MD
Provider details
- NPI number
- 1700167616
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 015066 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
600 N Wolfe St
Baltimore, MD 21287-0005
Phone: (410) 955-6070
Fax: (410) 955-0833
Approximate (ZIP-level) locationGet directions
Mailing address
6201 Greenleigh Ave
Middle River, MD 21220-2004
Additional practice locations (1)
- 525 E 68th StNew York, NY 10065-4870Phone: (212) 746-5454
Registry dates
- Enumerated
- 2011-09-06
- Last updated
- 2024-08-08
- Certified
- 2024-08-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.