Provider Demographics
NPI:1225030943
Name:SUBURBAN WOMEN'S HEALTHCARE PC
Entity Type:Organization
Organization Name:SUBURBAN WOMEN'S HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-876-5512
Mailing Address - Street 1:4041 DELAWARE AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150
Mailing Address - Country:US
Mailing Address - Phone:716-876-5512
Mailing Address - Fax:716-876-7342
Practice Address - Street 1:4041 DELAWARE AVE
Practice Address - Street 2:STE 100
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150
Practice Address - Country:US
Practice Address - Phone:716-876-5512
Practice Address - Fax:716-876-7342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
14352AMedicare ID - Type Unspecified