Provider Demographics
NPI:1861671927
Name:BAUMGARTEL ZANGARDI MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:BAUMGARTEL ZANGARDI MEDICAL ASSOCIATES
Other - Org Name:BAUMGARTEL MEDICAL ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAUMGARTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-625-2550
Mailing Address - Street 1:PO BOX 1048
Mailing Address - Street 2:504 PITTSBURGH STREET
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-9998
Mailing Address - Country:US
Mailing Address - Phone:724-625-2550
Mailing Address - Fax:724-625-1034
Practice Address - Street 1:504 PITTSBURGH STREET
Practice Address - Street 2:
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046-9998
Practice Address - Country:US
Practice Address - Phone:724-625-2550
Practice Address - Fax:724-625-1034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020872E174400000X, 207R00000X
PAMD432912207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA081498Medicare PIN