Provider Demographics
NPI:1336102235
Name:GARZARELLI, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GARZARELLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MELLON WAY
Mailing Address - Street 2:UPMC ST MARGARET HOSPITAL
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1197
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 MELLON WAY
Practice Address - Street 2:UPMC ST MARGARET HOSPITAL
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1197
Practice Address - Country:US
Practice Address - Phone:724-537-1801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027918E208M00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0982453Medicaid
PA0982453Medicaid
PA033596Medicare PIN