Provider Demographics
NPI:1831370998
Name:WARREN JAY ZALUT,MD,PC
Entity type:Organization
Organization Name:WARREN JAY ZALUT,MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:ZALUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-947-8496
Mailing Address - Street 1:2600 PHILMONT AVE
Mailing Address - Street 2:SUITE 217
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-5306
Mailing Address - Country:US
Mailing Address - Phone:215-947-8496
Mailing Address - Fax:215-968-3373
Practice Address - Street 1:2600 PHILMONT AVE
Practice Address - Street 2:SUITE 217
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-5306
Practice Address - Country:US
Practice Address - Phone:215-947-8496
Practice Address - Fax:215-968-3373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018520E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005995390005Medicaid
PA3513707000OtherINDEPENDENCE BLUE CROSS
PA001519093OtherHIGHMARK BLUE SHIELD
PA0046391000OtherINDEPENDENCE BLUE CROSS
PA0046391000OtherINDEPENDENCE BLUE CROSS
PA3513707000OtherINDEPENDENCE BLUE CROSS