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:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2621
Mailing Address - Country:US
Mailing Address - Phone:814-944-7383
Mailing Address - Fax:814-944-7608
Practice Address - Street 1:615 6TH AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-2621
Practice Address - Country:US
Practice Address - Phone:814-944-7383
Practice Address - Fax:814-944-7608
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
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