Provider Demographics
NPI:1093774929
Name:WOMEN'S CANCER CENTER OF CENTRAL PA, P.C.
Entity Type:Organization
Organization Name:WOMEN'S CANCER CENTER OF CENTRAL PA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MISAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-221-5940
Mailing Address - Street 1:3901 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-1581
Mailing Address - Country:US
Mailing Address - Phone:717-221-5920
Mailing Address - Fax:717-233-2821
Practice Address - Street 1:3901 N FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1581
Practice Address - Country:US
Practice Address - Phone:717-221-5920
Practice Address - Fax:717-233-2821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA884796Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER