Basic Information
| Provider Information | |||||||||
| NPI: | 1992784425 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DELBAGGIO | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11279 PERRY HWY | ||||||||
| Address2: | SUITE 450 | ||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150909381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249331100 | ||||||||
| FaxNumber: | 7249331160 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 S LOGAN BLVD | ||||||||
| Address2: | SUITE 1200 | ||||||||
| City: | HOLLIDAYSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166483050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8149467568 | ||||||||
| FaxNumber: | 8149437490 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2006 | ||||||||
| LastUpdateDate: | 04/19/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD070856L | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.