Provider Demographics
NPI:1659770964
Name:WHCGPA CENTER FOR BREAST HEALTH
Entity Type:Organization
Organization Name:WHCGPA CENTER FOR BREAST HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-831-0200
Mailing Address - Street 1:PO BOX 1109
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OAKS
Mailing Address - State:PA
Mailing Address - Zip Code:19456-1109
Mailing Address - Country:US
Mailing Address - Phone:610-482-4778
Mailing Address - Fax:610-666-3310
Practice Address - Street 1:4 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1605
Practice Address - Country:US
Practice Address - Phone:610-994-1136
Practice Address - Fax:215-687-4775
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMENS HEALTH CARE GROUP OF PENNSYLVANIA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA085603Medicare PIN