Provider Demographics
NPI:1821192816
Name:GI MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:GI MEDICAL ASSOCIATES
Other - Org Name:GEORGE ISAJIW MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAJIW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-626-4397
Mailing Address - Street 1:23 N LANSDOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050
Mailing Address - Country:US
Mailing Address - Phone:610-626-4397
Mailing Address - Fax:
Practice Address - Street 1:23 N LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050
Practice Address - Country:US
Practice Address - Phone:610-626-4397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012611E207R00000X, 311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care FacilityGroup - Single Specialty