Provider Demographics
NPI:1710932322
Name:GYNO ASSOCIATES
Entity Type:Organization
Organization Name:GYNO ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-539-8581
Mailing Address - Street 1:1010 LIGONIER ST
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1882
Mailing Address - Country:US
Mailing Address - Phone:724-539-8581
Mailing Address - Fax:724-539-1575
Practice Address - Street 1:1010 LIGONIER ST
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1882
Practice Address - Country:US
Practice Address - Phone:724-539-8581
Practice Address - Fax:724-539-1575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007444810006Medicaid
PA1007444810005Medicaid
PA067988OtherBS
PA1006226OtherGATEWAY
PA63093OtherUNISON
PAV02311OtherUPMC
PA023111OtherUNITED HEALTHCARE
PAV02311OtherUPMC
PA067955Medicare UPIN