Basic Information
| Provider Information | |||||||||
| NPI: | 1376519199 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GEMZIK | ||||||||
| FirstName: | TRACEY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1569 MEDICAL DR | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | POTTSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194643223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103274200 | ||||||||
| FaxNumber: | 6103278160 | ||||||||
| Practice Location | |||||||||
| Address1: | 555 GLASGOW ST | ||||||||
| Address2: | |||||||||
| City: | STOWE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194646557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4849450770 | ||||||||
| FaxNumber: | 4849450648 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | OA002061 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.