Provider Demographics
NPI:1346294071
Name:PAZMINO, ROY ROLANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:ROLANDO
Last Name:PAZMINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:200 HOSPITAL DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TYRONE
Mailing Address - State:PA
Mailing Address - Zip Code:16686-1825
Mailing Address - Country:US
Mailing Address - Phone:814-684-4676
Mailing Address - Fax:814-684-3692
Practice Address - Street 1:200 HOSPITAL DR
Practice Address - Street 2:SUITE 2
Practice Address - City:TYRONE
Practice Address - State:PA
Practice Address - Zip Code:16686-1825
Practice Address - Country:US
Practice Address - Phone:814-684-4676
Practice Address - Fax:814-684-3692
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD041241E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011236870008Medicaid
PAB38555Medicare UPIN
PA0011236870008Medicaid