Provider Demographics
NPI:1295915684
Name:ZAMBELLI, GEORGE RAYMOND JR (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:RAYMOND
Last Name:ZAMBELLI
Suffix:JR
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 1:380 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:15074-2138
Mailing Address - Country:US
Mailing Address - Phone:724-728-5000
Mailing Address - Fax:724-728-3248
Practice Address - Street 1:380 ADAMS ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:PA
Practice Address - Zip Code:15074-2138
Practice Address - Country:US
Practice Address - Phone:724-728-5000
Practice Address - Fax:724-728-3248
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019985E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010371590003Medicaid
PA91740OtherAETNA
PAE55440OtherUPIN
PA1503486OtherGATEWAY
PA206043OtherUPMC
PA060837OtherPABS
PAE55440OtherCOVENTRY
PA5470440OtherCIGNA
PA91740OtherAETNA
PA060837Medicare PIN