Provider Demographics
NPI:1730154469
Name:WHITE ROSE OB/GYN ASSOCIATES
Entity type:Organization
Organization Name:WHITE ROSE OB/GYN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:RALPH
Authorized Official - Last Name:PICCOLO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-846-2168
Mailing Address - Street 1:1225 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-1250
Mailing Address - Country:US
Mailing Address - Phone:717-846-2168
Mailing Address - Fax:717-699-1300
Practice Address - Street 1:1225 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-1250
Practice Address - Country:US
Practice Address - Phone:717-846-2168
Practice Address - Fax:717-699-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003760L207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC31034Medicare UPIN
PAF80707Medicare UPIN