Provider Demographics
NPI:1235259995
Name:MARY ANNE A PAJEL-SIO MD PC
Entity Type:Organization
Organization Name:MARY ANNE A PAJEL-SIO MD PC
Other - Org Name:MARY ANNE A PAJEL-SIO MD PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:WYKOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-866-4201
Mailing Address - Street 1:2551 BAGLYOS CIRCLE
Mailing Address - Street 2:SUITE A10
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-8056
Mailing Address - Country:US
Mailing Address - Phone:610-866-4201
Mailing Address - Fax:
Practice Address - Street 1:2551 BAGLYOS CIR
Practice Address - Street 2:SUITE A-10
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8042
Practice Address - Country:US
Practice Address - Phone:610-866-4201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG08895Medicare UPIN