Basic Information
| Provider Information | |||||||||
| NPI: | 1669793816 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZATOR | ||||||||
| FirstName: | ZACHARY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1501 N CEDAR CREST BLVD STE 110 | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181042309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108212828 | ||||||||
| FaxNumber: | 6108217915 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 N CEDAR CREST BLVD STE 110 | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181042309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108212828 | ||||||||
| FaxNumber: | 6108217915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2010 | ||||||||
| LastUpdateDate: | 05/26/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 05/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MD456853 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 1034988190002 | 05 | PA | MEDICAID |