Provider Demographics
NPI:1528022373
Name:BAYZICK, BRIAN MATTHEW (DC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:MATTHEW
Last Name:BAYZICK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 LOUIS DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2844
Mailing Address - Country:US
Mailing Address - Phone:215-957-5400
Mailing Address - Fax:215-957-5401
Practice Address - Street 1:600 LOUIS DR
Practice Address - Street 2:SUITE 202
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-2844
Practice Address - Country:US
Practice Address - Phone:215-957-5400
Practice Address - Fax:215-957-5401
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC8629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2225058000OtherKEYSTONE HEALTH PLAN EAST
PA001539943OtherBCBS
PA111N00000XOtherTAXONOMY
PA3546777OtherAETNA
PADD8623Medicare ID - Type UnspecifiedRAILROAD MEDICARE
PA111N00000XOtherTAXONOMY
PA3546777OtherAETNA