Provider Demographics
NPI:1508858770
Name:ZALUT, WARREN JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:JAY
Last Name:ZALUT
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 1:2600 PHILMONT AVE
Mailing Address - Street 2:SUITE 217
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-5306
Mailing Address - Country:US
Mailing Address - Phone:215-947-8496
Mailing Address - Fax:215-968-3373
Practice Address - Street 1:2600 PHILMONT AVE
Practice Address - Street 2:SUITE 217
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-5306
Practice Address - Country:US
Practice Address - Phone:215-947-8496
Practice Address - Fax:215-968-3373
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018520E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0001519093OtherHIGHMARK BLUE SHIELD
PA0046391000OtherINDEPENDENCE BLUE SHIELD
PA0046391000OtherINDEPENDENCE BLUE SHIELD
PA072272Medicare PIN