Provider Demographics
NPI:1609855014
Name:BABINECZ, JOHN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:BABINECZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:255 W LANCASTER AVE
Mailing Address - Street 2:330 PAOLI MOB III
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1763
Mailing Address - Country:US
Mailing Address - Phone:610-644-9233
Mailing Address - Fax:610-725-0938
Practice Address - Street 1:255 W LANCASTER AVE
Practice Address - Street 2:330 PAOLI MOB III
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1763
Practice Address - Country:US
Practice Address - Phone:610-644-9233
Practice Address - Fax:610-725-0938
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD030561E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB36252Medicare UPIN
PA096160HK1Medicare ID - Type Unspecified