1144239443 NPI number — MAGED M ZAKY MD, FACP

Table of content: (NPI 1043255243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144239443 NPI number — MAGED M ZAKY MD, FACP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZAKY
Provider First Name:
MAGED
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, FACP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144239443
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1414 NINTH AVE.
Provider Second Line Business Mailing Address:
1414
Provider Business Mailing Address City Name:
ALTOONA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-946-1655
Provider Business Mailing Address Fax Number:
814-949-7616

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1414 9TH AVE.
Provider Second Line Business Practice Location Address:
1414
Provider Business Practice Location Address City Name:
ALTOONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-946-1655
Provider Business Practice Location Address Fax Number:
814-949-7616
Provider Enumeration Date:
08/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD00044191 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: MD434892 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2063501 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 10219919100001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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