Provider Demographics
NPI:1881772036
Name:ELIZABETH TOWNSHIP FAMILY MEDICINE, PC
Entity type:Organization
Organization Name:ELIZABETH TOWNSHIP FAMILY MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:GORALCZYK
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:412-751-4661
Mailing Address - Street 1:300 SCENERY DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:PA
Mailing Address - Zip Code:15037-2051
Mailing Address - Country:US
Mailing Address - Phone:412-751-4661
Mailing Address - Fax:412-751-8811
Practice Address - Street 1:300 SCENERY DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:PA
Practice Address - Zip Code:15037-2051
Practice Address - Country:US
Practice Address - Phone:412-751-4661
Practice Address - Fax:412-751-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102273OtherDR SKINNER UPMCHP #
PA102594OtherDR GORALCZYK UPMCHP #
PA000136532OtherDR SKINNER HIGHMARK #
PA0007335100005Medicaid
PA750DOtherUPMC HEALTH PLAN GROUP #
PA000059418OtherDR GORALCZYK HIGHMARK #
PA001636633OtherHIGHMARK GROUP #
PA0007335470005Medicaid
PA1011166490001Medicaid
PA244337OtherHEALTH AMERICA GROUP #
PA0007335470005Medicaid
PA0007335100005Medicaid
PA001636633OtherHIGHMARK GROUP #
PAC31368Medicare UPIN
PA059418S8NMedicare ID - Type UnspecifiedDR ED GORALCZYK MDCR #
PA083899Medicare ID - Type UnspecifiedMEDICARE GROUP #