Provider Demographics
NPI:1992784425
Name:DELBAGGIO, REBECCA L (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:DELBAGGIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11279 PERRY HWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9381
Mailing Address - Country:US
Mailing Address - Phone:724-933-1100
Mailing Address - Fax:724-933-1160
Practice Address - Street 1:800 S LOGAN BLVD
Practice Address - Street 2:SUITE 1200
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-3050
Practice Address - Country:US
Practice Address - Phone:814-946-7568
Practice Address - Fax:814-943-7490
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2017-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD070856L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017998930001Medicare ID - Type Unspecified
PAH20317Medicare UPIN
PA039511Medicare ID - Type Unspecified