Basic Information
Provider Information
NPI: 1700378718
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZAGORSKI
FirstName: EMILY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 783311
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191783311
CountryCode: US
TelephoneNumber: 4848844500
FaxNumber:  
Practice Location
Address1: 1627 CHEW ST
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181023648
CountryCode: US
TelephoneNumber: 6109693390
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/05/2018
LastUpdateDate: 08/12/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/12/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XOS022037PAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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