Provider Demographics
NPI:1760487417
Name:READING OB/GYN & WOMEN'S BIRTH CENTER
Entity Type:Organization
Organization Name:READING OB/GYN & WOMEN'S BIRTH CENTER
Other - Org Name:READING BIRTH & WOMEN'S CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/DOCTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAMMARANO
Authorized Official - Suffix:III
Authorized Official - Credentials:DO
Authorized Official - Phone:610-777-7222
Mailing Address - Street 1:949 NEW HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-1646
Mailing Address - Country:US
Mailing Address - Phone:610-777-7222
Mailing Address - Fax:610-775-9534
Practice Address - Street 1:949 NEW HOLLAND RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-1646
Practice Address - Country:US
Practice Address - Phone:610-777-7222
Practice Address - Fax:610-775-9534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-19
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0S004956L261Q00000X
PA80093300261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015106170008Medicaid
PA0015106170011Medicaid