Provider Demographics
NPI:1649214446
Name:ZUWIALA, VINCENT G (DPM, FACFAS)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:G
Last Name:ZUWIALA
Suffix:
Gender:M
Credentials:DPM, FACFAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 STATE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HAMBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19526-1823
Mailing Address - Country:US
Mailing Address - Phone:610-562-4999
Mailing Address - Fax:610-562-0221
Practice Address - Street 1:260 STATE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526-1823
Practice Address - Country:US
Practice Address - Phone:610-562-4999
Practice Address - Fax:610-562-0221
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002677-L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010441170005Medicaid
PA20015365OtherAMERIHEALTH
PA0020402000OtherINDEPENDENCE BLUE CROSS
PA01175201OtherBLUE CROSS
PA47793OtherBLUE SHIELD
PA20015365OtherAMERIHEALTH
PAT27356Medicare UPIN