Provider Demographics
NPI:1477542868
Name:ZAL, ALICE J (DO)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:J
Last Name:ZAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:216 GOLDENROD DR
Mailing Address - Street 2:
Mailing Address - City:UPPER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19446-7606
Mailing Address - Country:US
Mailing Address - Phone:610-275-5599
Mailing Address - Fax:
Practice Address - Street 1:190 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 110
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-1385
Practice Address - Country:US
Practice Address - Phone:610-567-6967
Practice Address - Fax:610-567-6955
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2012-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOSOO212L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1524238Medicaid
721651Medicare ID - Type Unspecified
F27067Medicare UPIN