Basic Information
Provider Information
NPI: 1508865163
EntityType: 2
ReplacementNPI:  
OrganizationName: BERNARD S ZORANSKI D O P C
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Mailing Information
Address1: PO BOX 175
Address2:  
City: NORTHUMBERLAND
State: PA
PostalCode: 178570175
CountryCode: US
TelephoneNumber: 5709880925
FaxNumber:  
Practice Location
Address1: 1788 WILMINGTON PIKE
Address2: SUITE 2400
City: GLEN MILLS
State: PA
PostalCode: 193428181
CountryCode: US
TelephoneNumber: 6103589058
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/17/2005
LastUpdateDate: 07/21/2022
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AuthorizedOfficialLastName: REINARD
AuthorizedOfficialFirstName: JANIE
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AuthorizedOfficialTitleorPosition: BILLING AGENT
AuthorizedOfficialTelephone: 5709880925
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X PAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
001203705000105PA MEDICAID


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