Provider Demographics
NPI:1285684191
Name:MCGORRY, DENNIS M (DO)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:M
Last Name:MCGORRY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 HAMILTON BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3691
Mailing Address - Country:US
Mailing Address - Phone:610-437-0660
Mailing Address - Fax:
Practice Address - Street 1:3050 HAMILTON BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3691
Practice Address - Country:US
Practice Address - Phone:610-437-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003040L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA080072329OtherPALMETTO RR
PA103900OtherHIGHMARK PA BLUE SHIELD
PA01055805OtherCAPITAL BLUE CROSS
PA080072329OtherPALMETTO RR
PA01055805OtherCAPITAL BLUE CROSS