Provider Demographics
NPI:1265760763
Name:DONALD J. ZANDIER, JR., PC
Entity type:Organization
Organization Name:DONALD J. ZANDIER, JR., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZANDIER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA
Authorized Official - Phone:412-833-1800
Mailing Address - Street 1:2940 S PARK RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1686
Mailing Address - Country:US
Mailing Address - Phone:412-833-1800
Mailing Address - Fax:412-833-1818
Practice Address - Street 1:2940 S PARK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1686
Practice Address - Country:US
Practice Address - Phone:412-833-1800
Practice Address - Fax:412-833-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006051L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014998880003Medicaid