Provider Demographics
NPI:1649469057
Name:WOMEN'S OB/GYN ASSOCIATES
Entity type:Organization
Organization Name:WOMEN'S OB/GYN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KUSUM
Authorized Official - Middle Name:R
Authorized Official - Last Name:KANSAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-942-5466
Mailing Address - Street 1:714 6TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2626
Mailing Address - Country:US
Mailing Address - Phone:814-942-5466
Mailing Address - Fax:814-946-5055
Practice Address - Street 1:714 6TH AVENUE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-2626
Practice Address - Country:US
Practice Address - Phone:814-942-5466
Practice Address - Fax:814-946-5055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000956T6XMedicare PIN