Provider Demographics
NPI:1497813380
Name:HARMATZ, LEE J (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:J
Last Name:HARMATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6321 ROUTE 30 FL 2
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-9703
Mailing Address - Country:US
Mailing Address - Phone:724-671-1750
Mailing Address - Fax:724-523-7726
Practice Address - Street 1:6321 ROUTE 30 FL 2
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9703
Practice Address - Country:US
Practice Address - Phone:724-671-1750
Practice Address - Fax:724-523-7726
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047547L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014318540005Medicaid
PA0014318540005Medicaid
PA73895G8EMedicare ID - Type Unspecified
PA0014318540005Medicaid