Healthcare Provider Details

I. General information

NPI: 1861671927
Provider Name (Legal Business Name): BAUMGARTEL ZANGARDI MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 09/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 PITTSBURGH STREET
MARS PA
16046-9998
US

IV. Provider business mailing address

PO BOX 1048 504 PITTSBURGH STREET
MARS PA
16046-9998
US

V. Phone/Fax

Practice location:
  • Phone: 724-625-2550
  • Fax: 724-625-1034
Mailing address:
  • Phone: 724-625-2550
  • Fax: 724-625-1034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD020872E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD020872E
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD432912
License Number StatePA

VIII. Authorized Official

Name: DR. IRA E BAUMGARTEL
Title or Position: PHYSICIAN/PRESIDENT
Credential: M.D.
Phone: 724-625-2550