Provider Demographics
NPI:1023042355
Name:ZOLLNER, GREGORY P (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:P
Last Name:ZOLLNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:240 MIDDLETOWN BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1816
Mailing Address - Country:US
Mailing Address - Phone:215-757-5772
Mailing Address - Fax:215-757-5494
Practice Address - Street 1:240 MIDDLETOWN BLVD
Practice Address - Street 2:STE 200
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1816
Practice Address - Country:US
Practice Address - Phone:215-757-5772
Practice Address - Fax:215-757-5494
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD042432L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA740283Medicare ID - Type Unspecified
PAF54185Medicare UPIN