Provider Demographics
NPI:1417904863
Name:BETH A HANDWERGER MD
Entity Type:Organization
Organization Name:BETH A HANDWERGER MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDWERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-644-7744
Mailing Address - Street 1:1800 E LANCASTER AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1533
Mailing Address - Country:US
Mailing Address - Phone:610-644-7744
Mailing Address - Fax:610-644-7746
Practice Address - Street 1:1800 E LANCASTER AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1533
Practice Address - Country:US
Practice Address - Phone:610-644-7744
Practice Address - Fax:610-644-7746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070563L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH53562Medicare UPIN
PA75416Medicare ID - Type Unspecified