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Individual

MS. DEBORAH A BACESKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
105 W CHURCH ST, SOMERSET, PA 15501-2251
(814) 443-1451
(814) 444-8100
Mailing address
105 W CHURCH ST, SOMERSET, PA 15501-2251
(814) 443-1451
(814) 444-8100

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD020766E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000153392
KEYSTONE HEALTH PLAN WEST
PA
01
110031490
PALMETTO GBA
PA
01
25-1381943
UMWA
PA
01
251381943
UPMC
PA
01
BA153392
HIGHMARK BLUE SHIELD
PA
Enumeration date
11/03/2005
Last updated
07/08/2007
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