Provider Demographics
NPI:1952363525
Name:ZAHALSKY, ANDREW J (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:ZAHALSKY
Suffix:
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 1:1163 COUNTRY CLUB ROAD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063
Mailing Address - Country:US
Mailing Address - Phone:724-292-9404
Mailing Address - Fax:724-292-9128
Practice Address - Street 1:1163 COUNTRY CLUB RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1013
Practice Address - Country:US
Practice Address - Phone:724-292-9404
Practice Address - Fax:724-292-9128
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD418239174400000X
PAVP006402M363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered174400000XOther Service ProvidersSpecialist
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA390147Other390147
PA1390388OtherBLUE SHIELD
PA130506OtherUNISON
PA0018940410004Medicaid
PA2937436OtherAETNA
PA310804OtherUPMC
PA085188OtherHEALTH AMERICA
PA082184Medicare ID - Type Unspecified
PA130506OtherUNISON