Provider Demographics
NPI:1710062146
Name:ZEGEL, HARRY G (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:G
Last Name:ZEGEL
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 1:255 W LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1763
Mailing Address - Country:US
Mailing Address - Phone:610-648-1000
Mailing Address - Fax:
Practice Address - Street 1:255 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1763
Practice Address - Country:US
Practice Address - Phone:610-648-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018034E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2707525OtherAETNA
PA0057472000OtherKEYSTONE HEALTHPLAN EAST
PA0009209420015Medicaid
PA0092094206OtherAMERICHOICE
PA401063OtherBLUE SHIELD PA
PA0057472000OtherKEYSTONE HEALTHPLAN EAST
PAB41210Medicare UPIN
PA401063OtherBLUE SHIELD PA